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Vaginal hysterectomy

J J Amy1

  • 1Department of Gynaecology, Andrology and Obstetrics, Academisch Ziekenhuis, Vrije Universiteit Brussel, Brussels, Belgium.

The National Medical Journal of India
|May 1, 1997
PubMed
Summary
This summary is machine-generated.

This study demonstrates the successful application of vaginal hysterectomy for enlarged myomatous uteri, offering a viable surgical option for patients. Techniques like bisection and morcellation facilitated removal of large fibroid uteri through the vagina.

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Urogynecology

Background:

  • Uterine fibroids (myomas) can cause significant gynecological issues, often necessitating hysterectomy.
  • Vaginal hysterectomy is a preferred surgical approach due to its minimally invasive nature and faster recovery.
  • Managing large or myomatous uteri via vaginal hysterectomy presents unique surgical challenges.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of vaginal hysterectomy in patients with significantly enlarged uteri due to myomas.
  • To describe surgical techniques employed to manage large myomatous uteri during vaginal hysterectomy.
  • To assess the safety and efficacy of this approach in a prospective series.

Main Methods:

  • Prospective study of 14 patients undergoing vaginal hysterectomy for myomatous uteri (14-20 weeks' gestation size).

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  • Surgical techniques included bisection, myomectomy, morcellation, and coring to facilitate uterine removal.
  • Procedures were performed with or without bilateral oophorectomy or salpingo-oophorectomy.

    • Main Results:

    • All 14 procedures were completed successfully with no major complications.
    • Mean uterine weight was 639g, mean operating time was 84 minutes, and mean blood loss was 296ml.
    • Postoperative hospital stay averaged 3.7 days, with all patients fully recovered at follow-up.

    Conclusions:

    • Vaginal hysterectomy is a safe and effective surgical option for managing enlarged myomatous uteri.
    • Specific techniques like bisection and morcellation enable the successful removal of large fibroid uteri via the vaginal route.
    • This approach offers favorable outcomes, including short hospital stays and full patient recovery.