Impact of Preoperative Uterine Volume on Symptom Recurrence Following Vaginal Hysterectomy for Pelvic Organ Prolapse

Vaginal hysterectomy (VH) is the preferred minimally invasive technique for benign uterine conditions, such as uterine prolapse, due to its association with faster recovery, shorter hospital stays, and fewer complications compared to abdominal or laparoscopic approaches. Uterine volume is often considered a factor influencing surgical feasibility and potential complications.

In this retrospective cohort study, we included all women who underwent VH at our institute between January 2010 and December 2016, and validated patient-reported outcome measures to identify the relationship between uterus volume and the recurrence of symptoms.

One hundred thirty-three patients were included, of whom 65 had a uterine volume greater than 22.5 cm³. In a multiple linear regression analysis, uterine volume was independently associated with higher scores on the PFDI-20 (p = 0.045) and POPDI-6 (p = 0.006) after controlling for the patient's age, parity, and uterine prolapse stage. Complication rates using the DINDO score were comparable between the two groups, which showed a low and similar rate of DINDO 2 and a higher score.

Increased uterine volume is significantly linked to higher postoperative scores on validated patient-reported outcome measures (PFDI-20 and POPDI-6), suggesting a potential impact on quality of life after surgery. These findings contribute to the ongoing discussion surrounding optimal patient selection for VH.