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A Experience with Non –Descent Vaginal Hysterectomy a Study as Natural Minimal Assisted Route

Dharasingh Meena** , Sumitra Bora* , Dharasingh Meena** , Ruchita Jain** , Hanslata Gehlot***

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New Indian Journal of Surgery 7(2):p 129-135, May-Aug 2016. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7216.9

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Abstract

 Aims: Purpose of this study is to put forward NON DESCENT VAGINAL HYSTERECTOMY as procedure of choice for the management of patients with non-malignant pelvic disease involving the uterus, whenever technically feasible. Methods: A prospective study carried out to determine the short term morbidity for vaginal hysterectomy done for non descent uterus. The study was done on 200 patients scheduled to undergo hysterectomy for benign conditions during the period of January 2007 to December 2012, at Umaid Hospital, Jodhpur. A written informed consent was taken from each patient. A preformed questionnaire was made for data collection. Exclusion criteria included were uterine size of more than (>20wks), restricted mobility of uterus, uterine malignancy, cervix flushed with vaginal vault, previous fistula repair and gross adenexal pathology. Observation: Total 200 hysterectomies were performed during the study period, vaginal route was employed in all patients but few of them converted to laprotomy(1%). Out of 200 vaginal hysterectomies maximum 68 (34%) patients were in age group 40-45 years.DUB is most common (42%) indication for the vaginal hysterectomies. Vaginal hysterectomies were successful in most of case but 2 case required laprotomy. Mean operative time was 50-60 minutes with 100-150 ml blood loss and mean average hospital stay was 4day. Complication was minimal except few had rectal (2%)injury. Conclusion: Non Descent Vaginal Hysterectomy is safe, minimally invasive natural orifice, scarless hysterectomy which can be done easily, faster with shorter anesthesia. Early and smooth post operative recovery, early return to work and cost effectiveness. For obese patients and patients with history of preexisting cardio-pulmonary disease there is excellent patients recovery with least complications.

Keywords: NDVH; Fibroid; Haemorrhage; Spinal Anesthesia.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7216.9

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