Comparison of vaginal natural orifice transluminal endoscopic surgery and vaginal hysterectomy for benign...

The aim of the study was to compare the surgical outcomes of vaginal natural orifice transluminal endoscopic surgery and conventional vaginal hysterectomy for benign gynecological conditions.

A prospective randomized controlled trial was conducted at a tertiary hospital from January 2025 to February 2025. Patients aged 40-80 who underwent hysterectomy for benign indications were included. Outcomes assessed included surgical outcomes, visual analog scale pain scores, and complication rates.

A total of 144 patients were included, with 72 undergoing vaginal natural orifice transluminal endoscopic surgery and 72 undergoing vaginal hysterectomy. No significant differences were found in demographic characteristics, surgical duration (100.8±14.1 min for vaginal natural orifice transluminal endoscopic surgery vs. 99.3±26.7 min for vaginal hysterectomy, p=0.646), or complication rates. The vaginal natural orifice transluminal endoscopic surgery group had a higher rate of bilateral salpingo-oophorectomy (97.2 vs. 36.1%, p<0.001) and required fewer non-steroidal anti-inflammatory drugs postoperatively (median 2.0 vs. 3.0, p=0.003).

This study indicates that vaginal natural orifice transluminal endoscopic surgery is a feasible alternative to vaginal hysterectomy for benign hysterectomies, demonstrating comparable outcomes and potential benefits in postoperative pain management. Future multi-center studies are warranted to strengthen the evidence base and explore long-term outcomes.