[Vaginal hysterectomy with bilateral adnexectomy]

Area of Science:

• Gynecologic Surgery
• Surgical Pathology
• Oncology

Context:

• A retrospective study compared 102 cases of vaginal hysterectomy with bilateral adnexectomy (UE.A.) to 102 cases of vaginal hysterectomy without adnexectomy (VK) performed between 1975-1980.
• The average age differed significantly (UE.A.: 51.9 years vs. VK: 36.8 years), while parity was balanced.
• Uterine myomatosus was the primary indication for surgery in both groups.

Purpose:

• To compare the complication rates of vaginal hysterectomy with and without bilateral adnexectomy.
• To evaluate the incidence and types of ovarian pathology found during adnexectomy in patients undergoing vaginal hysterectomy.

Summary:

• Postoperative complications, including bleeding and fever, were comparable between the UE.A. and VK groups.
• Ovarian pathology was identified in 52.9% of the UE.A. group, with benign ovarian tumors being the most frequent finding (46%).
• Other pathologies included ovarian tumors (4.9%), endometriosis (4.9%), breast carcinoma metastasis (0.9%), and tubal carcinoma with ovarian micrometastasis (0.9%).

Impact:

• This study suggests that bilateral adnexectomy can be performed concurrently with vaginal hysterectomy without a significant increase in immediate postoperative complications.
• The high rate of incidental ovarian pathology underscores the value of routine adnexal assessment and potential removal during hysterectomy, particularly in older age groups.
• Findings contribute to surgical decision-making regarding the extent of pelvic surgery in benign gynecologic conditions.