scholarly journals Feasibility of bilateral salpingo-oophorectomy during vaginal hystertectomy for benign uterine diseases

2019 ◽  
Vol 8 (5) ◽  
pp. 1757
Author(s):  
Kavitha G. ◽  
Anitha D.
Keyword(s):  
Vaginal Hysterectomy ◽  
Menopausal Status ◽  
Postoperative Recovery ◽  
Uterine Disease ◽  
Medical College ◽  
Duration Of Surgery ◽  
Adnexal Pathology ◽  
Almost All ◽  
Uterine Diseases ◽  
Ovarian Syndrome

Background: Prophylactic bilateral salpingo-oophorectomy (BSO) remains the best measure in the prevention of ovarian cancer as it lacks an effective screening tool. The need to perform prophylactic BSO shouldn't dictate the route of surgery. To assess the feasibility of prophylactic BSO during vaginal hysterectomy. To analyze the safety of the vaginal BSO.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynaecology at Velammal Medical College, Madurai, Tamilnadu, India from June 2016 to June 2018 over a period of 3 years. 54 women who underwent hysterectomy for benign uterine disease in whom concomitant prophylactic BSO was attempted were included in the study. Preoperative data like age, parity, menopausal status, BMI, previous pelvic surgeries were noted from the admission record. Intraoperative details like indication for surgery, surgical procedure, duration of surgery and complications like hemorrhage, bladder, ureter and bowel injury were collected from the operative record. Postoperative recovery details were also noted down from the case sheet. The collected data were then analyzed.Results: Of the 54 women included in the study, transvaginal BSO was successful in 53 (98.1%) women. There was one case of primary haemorrhage due to slippage of ovarian pedicle, another patient required laparotomy for completing BSO. None had bladder, ureter or bowel injury.Conclusions: Prophylactic BSO is both feasible and safe in almost all patients undergoing vaginal hysterectomy. Developing the skill to perform transvaginal BSO can inspire gynaecologists to move a step forward and deal with benign adnexal pathology concomitantly at vaginal hysterectomy. The risk of remnant ovarian syndrome post vaginal oophorectomy is unknown.

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

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 A clinical study of elective hysterectomies for benign lesions

2021 ◽  
Vol 10 (6) ◽  
pp. 2414
Author(s):  
Mamta Meena ◽  
Urvashi . ◽  
C. P. Kachawaha ◽  
Dharmendra Singh Fatehpuriya
Keyword(s):  
Clinical Study ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Safe Procedure ◽  
Benign Lesions ◽  
Duration Of Surgery ◽  
The Mean ◽  
Adnexal Pathology ◽  
Histopathological Report

Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women.

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 Safety and Feasibility of Non-descent Vaginal Hysterectomy in FaridpurMedical College Hospital

2019 ◽  
Vol 13 (2) ◽  
pp. 89-92
Author(s):  
Lutfun Naher ◽  
Nasrin Rosy ◽  
Biswanath Roy ◽  
Shafeya Khanam ◽  
Zebunnessa Parvin
Keyword(s):  
Vaginal Hysterectomy ◽  
College Hospital ◽  
Medical College ◽  
Gynecological Disorders ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Uterine Descent ◽  
Gynecological Disease ◽  
Benign Gynecological Disease ◽  
Febrile Morbidity

This Study was done to assess safety and feasibility of non-descent vaginal hysterectomy for benign gynecological disease. A prospective observational study was conducted over a sample size of 50 patients at the department of Obstetrics and Gynecology of Faridpur Medical College Hospital from 1st January 2017 to 31st December 2017. All patients requiring hysterectomy for benign gynecological disorders who did not have any uterine descent were recruited for this study. Non-descent vaginal hysterectomy was performed in cases where uterus was mobile with size not exceeding 16 weeks gestation and with adequate vaginal access. Morcellation techniques like bisection, myomectomy, wedge debulking or combinations of these were employed in bigger sized uterus. A total of 50 cases were selected for non-descent vaginal hysterectomy. Among these, 47 cases successfully underwent non-descent vaginal hysterectomy. Majority (44%) of the patients were in age group of 41-45 years. All patients were parous. Uterine size was <10 wks in 30 cases and >10 wks in 20 cases. Commonest indication was leiomyoma of uterus (46%). Mean duration of surgery was two hours. Mean blood loss was 200 ml. Reasons for failure to perform nondescent vaginal hysterectomy was difficulty in opening pouch of douglus in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. The most common complication was post-operative pain in 22% of cases. Febrile morbidity was present in 4% of cases. Blood transfusion was required in 7 cases. Average duration of hospital stay was three days. Vaginal hysterectomy for benign gynecological causes other than prolapse safe, feasible and patient friendly. Faridpur Med. Coll. J. Jul 2018;13(2): 89-92

scholarly journals A Review on Choosing the Preferable Route of Hysterectomy

2017 ◽  
Vol 25 (1) ◽  
pp. 72-73
Author(s):  
Mukti Rani Saha ◽  
Nahid Yasmin ◽  
Shammi Nasrin ◽  
Shahrin Ahmed ◽  
Fatema Mahbooba Akter
Keyword(s):  
Minimally Invasive Surgery ◽  
Vaginal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Blood Loss ◽  
Medical College ◽  
Operative Duration ◽  
Benign Pathology ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Analgesia Requirement

Introduction: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of vaginal Hysterectomy for non-prolapsed indications i.e. non decent vaginal Hysterectomy (NDVH) as the scar less Hysterectomy. It has several benefits over abdominal Hysterectomy in terms of cosmetic advantages, lesser post operatives morbidity and faster recovery.Objectives: The study was to compare and assess various factors like operative duration of surgery intra operative blood loss, intra operative and post operative complications, post operative analgesia requirement, post operative ambulation and duration of post operative hospital stay and to put forward best route of hysterectomy.Conclusions: Non-decent vaginal hysterectomy is a better alternative to abdominal hysterectomy in cases with benign pathology of the uterus, uterine size<14 weeks, uterus with good mobility and adequate vaginal access.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 72-73

Characteristics of Polycystic Ovarian Syndrome in Sub-fertile Woman Attending to GOPD in ShSMCH

2019 ◽  
Vol 11 (1) ◽  
pp. 17-23
Author(s):  
Jinnat Ara Islam ◽  
Fatema Ashraf ◽  
Eva Rani Nandi
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovaries ◽  
Cross Sectional ◽  
Medical College ◽  
Appropriate Treatment ◽  
Pcos Group ◽  
Symptom Complex ◽  
Ovarian Syndrome ◽  
Selection Of ◽  
Fertile Women

Background: Polycystic ovarian syndrome (PCOS) is a condition characterized by menstrual abnormalities (oligo/amenorrhea) and clinical or biochemical features of hyperandrogenism and may manifest at any age. It is a common cause of female subfertility. All the dimensions of PCOS have not been yet completely explored. Methods: It was a cross sectional comparative study carried out at-GOPD of Shaheed Suhrawardy Medical College & Hospital from January, 2016 to December 2016 on 162 subfertile women. Among them 54 were PCOS group and 108 were non PCOS group. PCOS was diagnosed by (Rotterdam criteria 2003) (i) Oligo or anovulation (ii) hyperandrogenism (iii) Polycystic ovaries. Study was done to evaluate and compare the demographic characteristics, clinical, biochemical and ultrasoundgraphic features of sub-fertile women with and without PCOS. Results: A total of 162 sub-fertile women aged 16-36 years. Mean age was 29.5±5.4. There were significant differences between the two groups in terms of (oligo/amenorrhea), hirsutism, WHR and ovarian ultrasound features. There were no significant differences between two groups in correlations between the level of obesity with the incidence of anovulation, hyperandrogenism or with hormonal features. Conclusion: PCOS is one of the important factors causing Infertility. It is an ill-defined symptom complex needed due attention. There is a need to increase awareness regarding. The clinical features of PCOS are heterogenous thus can be investigated accordingly of selection of appropriate treatment modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 17-23

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

Inter-Basal and Septal Connections of Papillary Muscles - An Anatomical Rationale for Rhythmic Opening of AV Valves - A Multicentric Medical College Based Cross Sectional Study

2021 ◽  
Vol 8 (31) ◽  
pp. 2865-2869
Author(s):  
Praveen Mulki Shenoy ◽  
Amith Ramos ◽  
Narasimha Pai ◽  
Bharath Shetty ◽  
Aravind Pallipady Rao
Keyword(s):  
Left Ventricle ◽  
Papillary Muscle ◽  
Interventricular Septum ◽  
Cross Sectional Study ◽  
Papillary Muscles ◽  
Cross Sectional ◽  
Medical College ◽  
Moderator Band ◽  
Almost All ◽  
And Function

BACKGROUND The papillary muscle basal connections have significant clinical implications. Variety of studies done on its morphology and function by various specialists in different departments. A close look on these revealed the interconnections of papillary muscles to one another and to the interventricular septum of both ventricles is related to uncoordinated contractions of papillary muscles, leading to hyper or hypokinesia or prolapse or even its rupture. METHODS Our study done in 25 formalin soaked hearts revealed after the deep and meticulous dissection, reflecting the walls of ventricles laterally the numerous interconnections of papillary muscles at its bases and IVS. Ventricles are opened by inverted ‘L’ shaped incision and its reflected more laterally till all the papillary muscles is visible in one frame after incising the moderator band. The connections were noted, measured, photographed, tabulated, compared with similar studies and analysed with experts with respective fields. RESULTS Almost all the specimens did have the interconnections. Further the post mortem findings of the cardiac related deaths with involvement of papillary muscles suggest damage to such ‘bridges’. The moderator band extensions to the base of right APM, and its extension to the posterior groups is noted in all the specimens. The bridge from the IVS to bases of both the groups of papillary muscles is noted in left ventricle. In90% of specimens the one PPM is found to be loosely connected, more so in left ventricle. CONCLUSIONS We are of a conclusion that such basal interconnections and to the interventricular septum are responsible for rhythmic contractions of papillary muscles of both ventricles. Since the AV valves have to open simultaneously, interconnections becomes mandatory as the impulse has to reach it before it reaches the trabeculae carniae. One of the Posterior papillary muscles is loosely connected to other papillary muscles, may be the reason for its rupture, more so in left ventricle. KEYWORDS Papillary Muscle, Interbasal Connection, Moderator Band, Valvular Prolapse, AV Valves

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