scholarly journals A pilot study evaluating the feasibility of non-descent vaginal hysterectomy for benign gynecological indications in women in rural India

2017 ◽  
Vol 6 (10) ◽  
pp. 4424
Author(s):  
Anjali Soni ◽  
Pawan Kumar Soni ◽  
Chanderdeep Sharma ◽  
Suresh Verma ◽  
Shivani Vashasit
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pilot Study ◽  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Vaginal Surgery ◽  
Pelvic Organ ◽  
Rural India ◽  
Duration Of Surgery ◽  
Abdominal Route

Background: Hysterectomy for benign indications is one of the common surgical procedures performed on women worldwide. Despite the available evidence favouring vaginal surgery still abdominal route is preferred in majority of women in rural India. Hence, this pilot study was done to determine the feasibility of Non-descent vaginal hysterectomy (NDVH) in rural India.Methods: All women planned for hysterectomy for benign indications (with no or minimal pelvic organ prolapse) during a period of six months were enrolled after taking informed consent and subsequently, underwent NDVH. Data was analyzed retrospectively with respect to duration of surgery, average blood loss, complications of surgery and duration of stay in the hospital.Results: All except one woman out of 37 women enrolled for the study had an un-eventful surgery with median duration of surgery [median 30 minutes; (range 30-55 minutes)], median hospital stay [(median 2 days) range 2-7 days], and minimal blood loss [median 50 ml (range 50-200 ml)]. There was one case of inadvertent cystotomy (diagnosed and repaired intra-operatively), and discharged in healthy condition on seventh post-operative day.Conclusions: NDVH is a safe option for hysterectomy (in women without pelvic organ prolapse) for benign indications even in rural India. It has been found to be associated with short hospital stay, minimal blood loss and short recovery time.

scholarly journals Surgical treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine

Medicina ◽  
2009 ◽  
Vol 45 (6) ◽  
pp. 440
Author(s):  
Rosita Aniulienė ◽  
Agnė Stankevičienė ◽  
Justina Kačerauskienė ◽  
Povilas Aniulis ◽  
Vitalija Druktenytė
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Obstetrics And Gynecology ◽  
Female Pelvic Organ Prolapse ◽  
Combined Operations ◽  
Surgical Methods

Objective. To compare surgical methods, complications, and outcomes in the treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine, and to disclose the risk factors that influence female pelvic organ prolapse. Material and methods. A retrospective analysis of surgeries for pelvic organ prolapse performed during the period of 2003–2007 was carried out. A total 823 women were operated on for pelvic organ prolapse. Results. During 2003–2007, 823 surgical procedures for the correction of female pelvic organ prolapse were performed at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine. Eighty (9.7%) patients underwent vaginal hysterectomy; 372 (45.3%), vaginal plastic operations (out of them, 23 were combined with TVT and 47 with TVT-O procedure); 360 (43.7%), vaginal hysterectomy with vaginal plastic surgeries; and 11 (1.3%), Prolift operations. The mean age of females was 62 years. Mean blood loss during operations was 162.1 mL. Patients undergoing vaginal plastic operations lost significantly less blood than those undergoing vaginal hysterectomy or combined operations (P<0.05). Mean time in surgery was 60.3 min. The duration of Prolift operations and vaginal plastic operations was significantly shorter than that of vaginal hysterectomy or combined procedures (vaginal hysterectomy + vaginal plastic surgery) (P<0.05). Mean hospital stay was 8.1 days. Hospital stay after vaginal plastic operations was significantly shorter than after vaginal hysterectomy or combined operations. The shortest hospital stay was after Prolift operation (P<0.05). Complications were related to the type of operation performed. Conclusions. The most common operations in the surgical treatment of female pelvic organ prolapse were vaginal plastic operations and combined operations. The shortest time in surgery and lowest blood loss was in case of vaginal plastic operations. The shortest hospital stay was after Prolift operations. The highest rate of complications was observed in patients who underwent vaginal hysterectomies, the lowest – after Prolift operations.

scholarly journals A clinico-surgical outcome of vaginal hysterectomy with or without hydro dissection: a Quasi experimental study

2018 ◽  
Vol 7 (9) ◽  
pp. 3668
Author(s):  
Kirti M. Hurakadli ◽  
L. L. Pujari ◽  
Prashant G.
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Intraoperative Blood Loss ◽  
Duration Of Surgery ◽  
Quasi Experimental ◽  
Abdominal Route ◽  
The Mean ◽  
Lower Morbidity

Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid   return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.

scholarly journals Non-descent vaginal hysterectomy for large uterus-safety and feasibility

2018 ◽  
Vol 7 (9) ◽  
pp. 3563
Author(s):  
Rameshkumar R. ◽  
Sahana N. Naik ◽  
Dhanalakshmi .
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Cost Effective ◽  
Cost Effective Method ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Large Uterus ◽  
Duration Of Operation ◽  
Post Operative Complications

Background: Non Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. The objective of the present study was to assess safety and feasibility of NDVH in patients with large uterus (>12 weeks size uterus).Methods: Retrospective study was conducted in Department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences and Hospital, Dharwad, India from May2014 to May 2017. Effort was made to perform hysterectomies vaginally in women with benign conditions with large uterine size. Information regarding age, parity, uterine size, blood loss, duration of operation, number of fibroids, other surgical difficulties encountered, intra–operative and post-operative complications were recorded.Results: Total of 65 cases was selected for NDVH with large uterine size. All successfully underwent NDVH. 25 patients had uterus of 10-12 weeks size, 17 had uterine size of 12-14 weeks size. Mean duration of surgery was 90 min. Mean blood loss was 300ml. Post-operative complications were minimal. All patients had early mobility with faster resumption to daily activities. Mean hospital stay was 4-5 days.Conclusions: Non descent vaginal hysterectomy is safe, cost effective method of hysterectomy in women with large uterus requiring hysterectomy for benign conditions with less complications, shorter hospital stay and less morbidity.

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Average Duration ◽  
Uterine Prolapse ◽  
Rational Approach ◽  
Medical College ◽  
Gynecological Disorders ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

2016 ◽  
Vol 30 (1) ◽  
pp. 15-19
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Fahmida Khan ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Prospective Observational Study ◽  
Average Duration ◽  
Target Population ◽  
Bladder Injury ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Duration Of Surgery ◽  
Abdominal Route

Objective(s): The aim of the study wasto evaluate the safety and feasibility of non-descent vaginal hysterectomy in advancing gynaecological practice.Materials and methods: This prospective observational study was conducted from 1st July 2013 to 31st June 2014 in Obstetrics and Gynaecology Department of Kumudini Women’s Medical College & Hospital, Mirzapur, Tangail. Fifty patients who needed hysterectomy for benign gynaecological disorders and who had no descent of uterus or vagina were the target population for this study. Main outcome measures were i) difficulty of operation, ii) procedures for overcoming the difficulties,iii) switch over to abdominal route, iv) time taken to complete the operation, v) blood loss during operation vi) need of blood transfusion and vii) postsurgical hospital stay.Results: In all (100%) cases vaginal hysterectomy was completed successfully. Commonest age group (46%) was between 41-45 years. All patients were parous. Size of the uterus was less then 8 wks in 21 cases, 8wks to 12 wks in 27 cases and more than 12 wks in 02 cases. Commonest indication was dysfunctional uterine bleeding (DUB) (44%). Mean duration of surgery was 50.5 ± 5.46 minutes. Mean blood loss was 100± 22.43 ml.Blood transfusion was required in four cases. Average duration of hospital stay was 3.1± 1.2 days. Complications were minimum which included, bladder injury, UTI and Vault infection.Conclusions: In properly selected cases non-descent vaginal hysterectomy is safe, feasible and patient friendly.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 15-19

scholarly journals Comparison of Intra-Operative and Post-Operative Complications between Non-Descent Vaginal Hysterectomy and Total Abdominal Hysterectomy

2018 ◽  
Vol 8 (3) ◽  
pp. 128-134
Author(s):  
Sayma Afroz ◽  
Gulshan Ara
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Blood Loss ◽  
Operative Complications ◽  
Abdominal Route ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologists and can be done through abdominal and vaginal routes. Vaginal hysterectomy technique has been introduced and performed centuries back, but is less popular due to lack of experience and misconception that the abdominal route is easier and safer. Worldwide gynaecologists continue to use abdominal route for hysterectomy that could be performed vaginally which is less invasive and has minimal complications.Objective: To compare the complications during intra-operative and post-operative period between vaginal hysterectomy and abdominal hysterectomy in non-descent uterus.Materials and Methods: This prospective randomised study was performed in Enam Medical College & Hospital, Savar, Dhaka during a period of one year. Sixty consecutive patients requiring hysterectomy for benign diseases were included in this study. Group A (n=30) underwent vaginal hysterectomy (non-descent vaginal hysterectomy) and were compared with Group B (n=30) who underwent abdominal hysterectomy. The primary outcome measures were operative time, intra-operative blood loss, post-operative complications like wound infection, febrile morbidity, post-operative systemic infection and hospital stay. Secondary outcome measures were conversion of vaginal to abdominal route and re-laparotomy. Data were collected in structured questionnaire and analysed by computer using R programming version 3.4.3.Results: Baseline characteristics were similar in two groups. There were no intra-operative complications in either group. Intra-operative blood loss was significantly more in Group B than in Group A. The overall complication rate was significantly higher with abdominal hysterectomy with a rate of 56.67% against 30% for vaginal hysterectomy. Wound infection (23.33%) was significantly higher in Group B as compared to Group A (0%). Post-operative hospital stay was significantly higher in Group B (7.03 days) than in Group A (4.57 days).Conclusion: Considering intra-operative blood loss, post-operative complications and hospital stay, vaginal route was found safer than abdominal route in this study.J Enam Med Col 2018; 8(3): 128-134

Vaginal hysterectomy with anterior and posterior repair for pelvic organ prolapse under local anesthesia: results of a pilot study

2020 ◽  
Vol 31 (10) ◽  
pp. 2109-2116
Author(s):  
Stavros Athanasiou ◽  
Dimitrios Zacharakis ◽  
Themos Grigoriadis ◽  
Theodoros Papalios ◽  
Eleni Pitsouni ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pilot Study ◽  
Local Anesthesia ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Posterior Repair

scholarly journals Comparison of morbidity associated with non-descent vaginal hysterectomy and total abdominal hysterectomy

2018 ◽  
Vol 7 (4) ◽  
pp. 1554
Author(s):  
Ranjita Ghadei ◽  
Gupteswar Mishra
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Stay Time ◽  
Normal Work

Background: In the present scenario of importance non-invasive surgery, there is increase in interest and requirement of vaginal hysterectomy for non-prolapsed uterus, i.e. non-descent vaginal hysterectomy (NDVH) due to its scarless surgery. it has much more advantages than that of abdominal hysterectomy in term of cosmesis, lesser duration of surgery, lesser intraoperative complication, lesser post-operative morbidity and early resumption to work. The aim of the present study is to asses and compare various factors like duration of surgery, intraoperative blood loss, intraoperative and postoperative complication postoperative morbidities, pain perception on 3rd post-operative day, post-operative ambulation, duration of hospital stay, time taken to resume normal work, follow up complains and afterall to decide the appropriate route of hysterectomy for benign conditions.Methods: Hundreds of patients were selected as per the criteria. They were divided into two groups NDVH (non-descent vaginal hysterectomy) and TAH (total abdominal hysterectomy) according to the inclusion criteria. Above mentioned factors are compared between the two groups.Results: Duration of surgery, intraoperative blood loss, intraoperative complications, post-operative morbidities and complications, duration of hospital stay, time required to resume normal work are less in NDVH group.Conclusions: Non-descent vaginal hysterectomy is a better alternative to abdominal hysterectomy for benign conditions.

scholarly journals Non-descent Vaginal Hysterectomy: Safety and Feasibility

2014 ◽  
Vol 7 (2) ◽  
pp. 14-16
Author(s):  
R Saha ◽  
NS Shrestha ◽  
M Thapa ◽  
J Shrestha ◽  
J Bajracharya ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
College Teaching ◽  
Successful Outcome ◽  
Transverse Diameter ◽  
Medical College ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
Adnexal Pathology

Aims: To assess safety and feasibility of non-descent vaginal hysterectomy. Methods: A hospital based prospective study was conducted at the department of obstetrics and gynecology of Kathmandu Medical College Teaching Hospital from 1st January 2010 to 31st December 2011. All the patients undergoing non -descent vaginal hysterectomy for benign indication, without suspected adnexal pathology were included in the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size ,estimated blood loss, length of operation, complication and hospital stay were recorded. Results: A total of 50 cases were selected for non-descent vaginal hysterectomy. Among them 43 cases successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 40%. All patients were parous. Uterus size was <10 weeks in 27 cases and >10 weeks in 23 cases. Commonest indication was leiomyoma of uterus (63%). Mean duration of surgery was two hours. Mean blood loss was 205.26ml. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in three cases. In rest of four cases there was difficulty in reaching the myoma and transverse diameter was too large so as to prevent descent of the uterus. The most common complication was post –operative pain in 23% of cases. Febrile morbidity was present in 4.6% of cases. Blood transfusion was required in seven cases. Average duration of hospital stay was three days. Conclusions: Vaginal hysterectomy for benign gynecological causes other than prolapse is safe and feasible. For successful outcome size of uterus, size in all dimensions and location of fibroid should be taken into consideration.Today in the era of minimally invasive surgery, non descent vaginal hysterectomy needs to be considered and seems to be a safe option. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11134   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 14-16

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