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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Vaginal hysterectomy for benign disorders in obese women: a prospective study
Arash Rafii1, Emmanuel Samain, Michel Levardon
1Department of Gynaecology and Obstétrics, Hôpital Beaujon, 92110 Clichy, France.
Objective:
To compare the morbidity of vaginal hysterectomy in obese and non-obese women in a single institution.
Design:
Obese and non-obese women with benign uterine disorders matched for age, parity and race underwent vaginal hysterectomy without laparoscopic assistance. Peri-operative outcome complications were compared. Thirty-eight women had a BMI over 30 kg/m(2) (study group) and 178 women had a BMI below 30 kg/m(2) (control group).
Setting:
Gynaecologic department of a university hospital.
Population:
Women who were referred to our department with an indication of vaginal hysterectomy for benign disorders.
Methods:
Case control study.
Main Outcome Measures:
Peri-operative complications, the fall in the haemoglobin concentration, the duration of the procedure, the length of the hospital stay and uterine weight were analysed.
Results:
Mean BMI was 33.2 and 23.7 kg/m(2) in the study and control groups, respectively. None of the obese women had severe co-morbidity contraindicating surgery. There were no significant differences in surgical or anaesthetic risk factors, including parity, hormonal status, pre-existing disease and estimated mean uterine weight. The overall complication rates were 14% and 16% in the obese and non-obese groups, respectively (P= 0.7). Obesity did not increase the duration of the procedure (48 [7] minutes vs 50 [10] minutes, P= 0.1) or the length of hospitalisation (5.8 [1.4] days vs 5.5 [1.2] days, P= 0.2).
Conclusion:
Vaginal hysterectomy can be successfully performed, with acceptable morbidity, in obese women.
