A comparative study of non-descent vaginal hysterectomy and total laparoscopic hysterectomy

Authors

  • Vijay Kansara Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India
  • Jaydeep Chaudhari Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India
  • Ajesh Desai Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20200376

Keywords:

Laparoscopic hysterectomy, Non-descent vaginal hysterectomy

Abstract

Background: Hysterectomy is the second most common operation performed by the gynecologists, next only to caesarean section. Objective of the study was to compare fall in blood haemoglobin level, duration of operation, intra- and post-op complications between non-descent vaginal hysterectomy and total laparoscopic hysterectomy and establish the better method for hysterectomy in non-descent uterus.

Methods: A retrospective comparative study of 90 hysterectomies was done from a period of May 2018 - April 2019 at GMERS Medical College and Hospital Sola, with 45 cases in group of non-descent vaginal hysterectomy (NDVH) and 45 in group of total laparoscopic hysterectomy (TLH). Demographic characteristics, co-morbid conditions, indications for surgery, operative time, intra- operative blood loss, post-operative analgesia requirements, post-operative hospital stay and post-operative complications were compared between both groups. Those patients having malignancy as diagnosed by Pap smear or by D and C were excluded from the study

Results: The most common age in both groups was 41-50 years. Adenomyotic uterus was the most common indication for surgery in both groups. The mean operative time in NDVH group was 45 min while it was 80 min in TLH group. p<0.001 suggested significant difference when operative time were compared between both groups. Both groups were similar in post-operative analgesia requirement and post-operative hospital stay. Post-operative complications were similar in both groups.

Conclusions: In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, technology available in the hospital and preference of patient as well as surgeon.

References

Balakrishnan D, Dibyajyoti G. A comparison between non descent vaginal hysterectomy and total abdominal hysterectomy. J Clin Diagn Res. 2016;10(1):11-4.

Gayathri KB, Sajana G, Manjusha P. Non descent vaginal hysterectomy for benign gynaecological disease: an institutional study on safety and feasibility from South India. IOSR J Dent Med Sci. 2017;16(11):59-63.

Mehta K, Prakash O, Fatehpuriya DS. Comparative study of abdominal hysterectomy and vaginal hysterectomy in non descent cases - a prospective study. Int J Reprod Contracept Obstet Gynaecol. 2017;6(4):1265-70.

Dewan R, Agarwal S, Minocha B, Sen SK. Non-descent vaginal hysterectomy - an experience. J Obstet Gynecol India. 2004;54(4):376-8.

Davies A, Wizza E, Bournas N. How to increase the propor-tion of hysterectomies performed vaginally. Am J Obstet Gynaecol. 1998;179:1008-12.

Mazdisnian F, Kurzel RB, Coe S. Vaginal hysterectomy by uterine morcellation: effecient, non-morbid procedure. Obstet Gynaecol. 1995;86:60-4.

Bhadra B, Choudary AP, Tolassaria A. Non-descent vaginal hysterectomy (NDVH): personal experiences in 158 cases. AL Ameen J Med Sci. 2011;4(1):23-7.

Chakraborty S, Goswami S, Mukherjee P. Hysterectomy which route? J Obstet Gynaecol India. 2011;61(5):554-7.

Fuzayel AB, Bhadra B, Choudhury N, Shyam DJ. Total laparoscopic hysterectomy versus non –descent vaginal hysterectomy: an observational study. Int J Recent Trends Sci Tech. 2017;24(2):40-3.

Shanthi S, Rani SU, Arumaikannu J. Feasibility of non-descent vaginal hysterectomy (NDVH) in women with scarred uterus-our experience. Int J Clin Obst Gynaecol. 2017;1(2):76-9.

Patel R, Chakravarty N. Comparative study of laparoscopic hysterectomy versus vaginal hysterectomy. Int J Med Sci Public Health. 2014;3(3):335-7.

Roy KK, Goyal M, Singla S, Sharma JB, Malhotra N, Kumar S. A prospective randomised study of total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus. Arch Gynecol Obset. 2011;284(4):907-12.

Summitt RL, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol. 1992;80(6):89-92.

Topadhyay S, Patra KK, Halder M, Mandal A, Pal P, Bhattacharyya S. A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):1109-12.

Shinde S, Aher G, Gavali U. Non-descent vaginal hysterectomy (NDVH): Our experience at a tertiary care centre. Indian J Basic Applied Med Res. 2015;5(1):132-7.

Mehta ST, Trivedi YN, Bhalodia P. Role of non-descent vaginal hysterectomy in advancing gynaecological practice. NHL J Med Sci. 2014;3(1):55-8.

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Published

2020-01-28

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Original Research Articles