Vaginal Hysterectomy For Conditions Other than Prolapse.

Abstract

Hysterectomy can be carried out safely by vaginal route for conditions other than prolapse, on an enlarged uterus and in the presence of previous pelvic surgery. This prospective study spans from Sep. 97 to Aug 98 and was carried out on patients undergoing vaginal hysterectomy for various indication other than prolapse. Main outcome measures noted were Vaginal rout, size of uterus, method used to reduce uterine size, operation time, intraoperative, post operative complications and duration of hospital stay. Fifty- one hysterectomies were carried out by vaginal route in Fibroid uterus (11), adenomyosis (9), Dysfunctional uterine bleeding (30), Post menopausal bleeding (2) and Cervical intraepithelial neoplasia (2). Size of the uterus ranged from 4 to 16 weeks size. Nineteen patients had previous pelvic surgery. Oophorectomy was done in 5 cases. The operation time ranged from 30 – 180 minutes. In 3 patients bladder was repaired successfully at the same time. In three patients hysterectomy has to be completed abdominally. Duration of hospital stay ranged from 3-9 days. There was no death. No major post operative complications related to anaesthesia or surgery occurred. Vaginal hysterectomy can be carried out in the above cited conditions with considerable advantages to the patient. Gynaecologists should persist in perfecting themselves in the technique of vaginal hysterectomy. More hysterectomies should be carried out vaginally without resorting to abdominal or laparoscopic surgery.