Vaginal hysterectomy for the large uterus

Area of Science:

• Gynecology
• Minimally Invasive Surgery

Background:

• Vaginal hysterectomy for enlarged uteri is rarely performed in Malaysia, with abdominal hysterectomy being the standard approach.
• Enlarged uteri, defined as >12 weeks size (>280g), present surgical challenges.

Purpose of the Study:

• To evaluate the feasibility and safety of performing vaginal hysterectomy for enlarged uteri in a private hospital setting.
• To assess the outcomes and complication rates of this surgical approach.

Main Methods:

• A personal series of 40 vaginal hysterectomies for uteri weighing 290g to 790g (mean 434g) was conducted between January 1997 and September 2000.
• Data collected included operating time and complication rates.

Main Results:

• The average operating time was 92.1 minutes.
• Complications were minimal, including 2 cases requiring blood transfusion for hemorrhage, 1 case of fever, and 1 case of bladder perforation.

Conclusions:

• Vaginal hysterectomy is a feasible and safe surgical option for enlarged uteri.
• The excellent recovery associated with avoiding an abdominal scar provides a strong incentive for surgeons to adopt this technique.