Study of Safety and Feasibility of Non-Descent Vaginal Hysterectomy in Modern Gynaecological Practice

Abstract

BACKGROUND Vaginal route of hysterectomy is being reinvented as a part of enhanced recovery with advantages of reduced operating time, lesser hospital stay, reduced morbidities and better patient satisfaction as scarless surgery. The aim of our study was to evaluate the safety and feasibility of non-descent vaginal hysterectomy. MATERIALS AND METHODS In this study, 78 cases with uterine size from normal to 18 weeks selected and operated after complete evaluation with valid consent. Operating time, blood loss, duration of hospital stay, intraoperative and postoperative complications were noted. Patients were followed up after two and six weeks. RESULTS The commonest age group in the study was 41-45 years (58.97%). Most common indication of hysterectomy was fibroid uterus (61.53%). The average operating time was 62 minutes with average blood loss of 220 mL and average hospital stay of 3-4 days. Only 2 cases developed major complications. One had primary haemorrhage requiring laparotomy, other developed ureterovaginal fistula requiring further surgery for repair. CONCLUSION NDVH is feasible, safe and can also be utilised for enlarged uterus upto 18 weeks, but descent and mobility of uterus, adequate vaginal space, uterine dimensions in both antero-posterior and transverse directions should be taken into account before contemplating NDVH.