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[Vaginal hysterectomy in nulliparous women: indications and limitations]
E Lambaudie1, B Occelli, M Boukerrou
1Pôle de Chirurgie Gynécologique, Hôpital Jeanne-de-Flandre, CHRU de Lille, place de Verdun, 59000 Lille, France.
Objective:
The aim of our study was to determine whether nulliparity is a limiting factor for vaginal hysterectomy performed for benign lesions.
Patients And Methods:
We conducted a prospective study in 1604 patients who underwent hysterectomy for a benign lesion between 1991 and 1998. We studied a subgroup of this population constituted by 128 nulliparous women, i.e. 8% of the patients.
Results:
Vaginal hysterectomy was performed at first intention in 54.7% of the cases, after laparoscopic preparation in 14%, and by first intention laparotomy in 31.3% for each type of approach we compared: history of pelvic surgery, duration of the operation, final weight of the uterus, peroperative complications, association or not with adnexectomy in patients aged 45 years or older, frequency of a reduction procedure in the vaginal group and duration of hospitalization.
Conclusion:
Nulliparity is not a contraindication for vaginal hysterectomy which can be proposed as a first intention procedure, sometimes in association with laparoscopic preparation in case of prior pelvic surgery or concomitant adnexal disorders.