Non-Descent Vaginal Hysterectomy: Safety and Feasibility
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 1
Abstract
Introduction: The rate of hysterectomy has varied between 6.1 and 8.6/1000 women of all ages. NDVH (Non- Descent Vaginal Hyterectomy) means removal of uterus with physiological descent and no prolapse via the vaginal route. Objective is to assess safety, feasibility of NDVH with respect to operative time, blood loss, intra operative and post -operative complications, hospital stay and Post-operative morbidity and to compare the above-mentioned variables in non-descent vaginal hysterectomy with the other two methods (VH and TAH). Materials and Methods: This study was done in tertiary care hospital in Obstetrics and Gynaecology department. The study duration was 1 and ½ years. It was a prospective interventional study comprising of 180 cases. 60 cases undergoing NDVH and 60 cases undergoing TAH for similar indications and 60 cases undergoing vaginal hysterectomy with descent. All the patients with benign indications, physiological descent and uterus less than or equal to 14 weeks size were included in study group. And time taken for surgery, complications, post-operative morbidity and stay were observed in all patients. Results: In our study, we found no difference in the intraoperative complications like haemorrhage requiring blood transfusion, accidental cysytotomy in all the three groups. Post-operative complications like febrile morbidity, wound infections were high in TAH (Total Abdominal Hysterectomy) group. Post-operative complications like febrile morbidity, wound infections, re-laparotomy, vault haematoma were significantly less (p value 0.0001) in NDVH group. Time taken for NDVH was significantly shorter (p value 0.0001) than TAH and VH (with descent). There was no difference in the time taken from application of first clamp till removal of the uterus in cases of NDVH, TAH and VH (Vaginal Hysterectomy) (with descent) group (p value 0.738). The fall in HB% in TAH and VH was more when compared to NDVH group (p value 0.002). Patients in NDVH age group ambulated earlier (p value 0.036). Post- operative stay in NDVH group was significantly shorter (p value-0.0001). Conclusion: From our study, it can be said that for uterus less than equal to 14 weeks size, vaginal approach of removing the uterus has got better outcomes in terms of fewer febrile morbidity and infections, faster recovery, shorter operative time, early return to normal activity and shorter hospital stay and better patient satisfaction in comparison with hysterectomy performed by abdominal route.
Authors and Affiliations
Nikita Y. Bharpoda, Kanishk Nayak
Keywords
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- EP ID EP531309
- DOI 10.21276/ijmrp.2018.4.1.133
- Views 87
- Downloads 0
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