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

scholarly journals Comparative study of abdominal hysterectomy and vaginal hysterectomy in non-descent cases a prospective study

2017 ◽  
Vol 6 (4) ◽  
pp. 1265 ◽  
Author(s):  
Kalpana Mehta ◽  
Om Prakash ◽  
Dharmendra Singh Fatehpuriya ◽  
Leena Verma
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Abdominal Hysterectomy ◽  
Operative Blood Loss ◽  
Operative Morbidity ◽  
Benign Pathology ◽  
Duration Of Surgery ◽  
Analgesia Requirement ◽  
A Prospective Study

Background: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of VH 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-operative morbidity and faster recovery. The objectives of 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.Methods: Hundred cases fulfilling, the selection criteria were included in the study. Patients were randomly divided in two groups-NDVH (non-decent vaginal hysterectomy) and abdominal hysterectomy.Results: Operative time, intra operative blood loss and post-operative morbidity was less in NDVH groups.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.

scholarly journals A Comparative evaluation of Non-descent vaginal hysterectomy versus total Abdominal hysterectomy: A hospital based case control study

2019 ◽  
Vol 17 (1) ◽  
pp. 20-22
Author(s):  
Durga BC ◽  
Aseem Sharma ◽  
Binod Mahaseth ◽  
Nirmala Sharma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Benign Pathology ◽  
Operative Complications ◽  
Control Study ◽  
Post Operative Complications

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

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

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 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 Retrospective analysis of elective hysterectomy cases in a tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3714
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Retrospective Analysis ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Fibroid Uterus ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Often hysterectomy remains the only option available in many gynaecological conditions, though it is resented by most women. This study aims to analyse the cases of hysterectomy performed in a tertiary care centre in India, with a view to modify and improve health care provided to women.Methods: A retrospective analysis of 500 cases of elective hysterectomy in Sree Gokulam Medical College and Research Foundation from January 2016 to December 2017 was done from hospital records. The observations according to age, indications of hysterectomy, route of hysterectomy and preservation of ovaries were statistically analysed.Results: 35.2% (176 cases) were between 45 and 50 years. Mean age was 48±2 years. 90.4% (452 cases) were done in women above 40 years of age. The commonest indication for hysterectomy was symptomatic fibroid uterus 59.4% (297 cases). 81.8% (409 cases) women underwent abdominal hysterectomy while 18.2 % (91 cases) women underwent vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy. 84.6% (77 of 91 cases) of vaginal hysterectomy was done for prolapse uterus. Preservation of one or both ovaries was done in 47.2% (236 cases).Conclusions: Hysterectomy is usually done after the age of 40 years with the mean age being 48±2 years. Symptomatic fibroid uterus was the most common indication. The rates of vaginal hysterectomy were lower for indications other than prolapse uterus. Ovaries were preserved in several cases.

scholarly journals Study of 46 nephrectomies in rural India

2021 ◽  
Vol 8 (10) ◽  
pp. 3036
Author(s):  
Pratik Gond ◽  
Mayur Gangwal ◽  
Gokul J. Jorwekar ◽  
Hrushikesh Wagholikar ◽  
Ruchita Talreja
Keyword(s):  
Blood Loss ◽  
Renal Calculi ◽  
The Other ◽  
Rural India ◽  
Malignant Diseases ◽  
Medical College ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Histopathological Report ◽  
Post Operative Complications

Background: The first planned nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelbergs since then nephrectomy has been an essential part of urologic practice. Elective nephrectomy is done for both benign and malignant diseases of the kidney. The objective of this study was to know the various causes their pre-op factors like age, gender, laterality of disease, and intra operative factors like duration of surgery, blood loss and post-operative complications and histopathological report of the nephrectomy specimens of elective nephrectomy in a rural medical college of IndiaMethods: In our series, we have studied all the elective nephrectomies done in Pravara Rural Hospital, Loni during a span of three years from January 2018 to March 2021.Results: We have analyzed 46 cases of nephrectomies regarding their pre-op factors like age, gender, laterality of disease, and intra operative factors like duration of surgery, blood loss and post-operative complications and histopathological report of the nephrectomy specimens. Out of 46 cases, 21 were males and 26 females. Comparing the laterality right nephrectomy was done in 41% cases and left nephrectomy in 59% cases. In our series, 76% cases of nephrectomies were done for benign causes and 24% cases for malignant causes. Among the benign causes, pyelonephritis was the leading cause followed by neglected renal calculi and resultant non-functional kidney. On the other hand, renal cell carcinoma was the most common malignant pathology requiring nephrectomy.Conclusions: In our series, majority cases of nephrectomies were done for benign causes.

scholarly journals Vaginal hysterectomy a safe option in non-descent uterus as compared to abdominal hysterectomy

2019 ◽  
Vol 8 (3) ◽  
pp. 1162
Author(s):  
Sona Singh ◽  
Vishal Gajbhiye
Keyword(s):  
Vaginal Hysterectomy ◽  
Transfusion Requirement ◽  
Controlled Trial ◽  
Abdominal Hysterectomy ◽  
Bladder Injury ◽  
Age Group ◽  
Medical College ◽  
Randomized Controlled ◽  
Safe Option ◽  
Gynecological Disorders

Background: The objective of present study was to compare the advantage of vaginal hysterectomy over abdominal hysterectomy in non-descent uterus.Methods: A non-randomized controlled trial was carried out in the Bundelkhand Medical College, Sagar and associated hospital from October 2015 to September 2017. A total of 150 cases were included in the study. Out on 150, 75 underwent vaginal hysterectomy for non-descent uterus and other 75 underwent abdominal hysterectomy for similar indications.Results: Among total 150 cases, 75 were underwent non-descent vaginal hysterectomy and similar number of cases underwent abdominal hysterectomy. Common age group was 35-54 years. Commonest indication was DUB (48.7%). Postoperatively, complications were more common in those who underwent abdominal hysterectomy such as ambulation (18 hours), incidence of nausea, vomiting, abdominal discomfort, bladder injury and wound infection were less in vaginal hysterectomy compared to abdominal hysterectomy. It was also observed that blood transfusion requirement, operative timing and hospital stay (3 days) were less in vaginal hysterectomy group.Conclusions: Vaginal hysterectomy for benign gynecological disorders is a safe, effective, least invasive and is associated with lesser complications as compare to abdominal hysterectomy. Today in the era where patient is more cosmetically concern, vaginal hysterectomy for non-descent uterine disorder needs to be considered as good and safe option.

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