Priyanka Singh1*, Han How Chuan2 and Marie Ann Chua Donsen3
1Department of Obstetrics and Gynecology, KK Women’s and Children’s Hospital, Singapore
2Department of Obstetrics and Gynecology, Mount Elizabeth Novena Specialist Centre, Singapore
3Department of Obstetrics and Gynecology, University of Cebu Medical Center, Philippines
Introduction and Hypothesis: Vaginal hysterectomy is a procedure which follows all the parameters of minimally invasive surgery. Because of the lower risk of intraoperative complications, possibility of using regional anesthesia, reduced infective morbidity, lesser pain and early return to routine activities, vaginal hysterectomy should be performed in preference to abdominal hysterectomy where possible. It can often be safely performed in women with prior caesarean section, nulliparity and a bulky uterus, after a thorough patient assessment. Long term follow up data from various studies show a low incidence of vault prolapse. Where feasible, the vaginal route should be preferred for hysterectomy. Methods: It was a retrospective study in which the case notes of 336 patients undergoing vaginal hysterectomy at a single center over a 5 year period were retrieved. The demographic profile, intraoperative and postoperative data and five year follow up details of these patients was evaluated. Results: The average age of the patients was 57 years and the most common indication for surgery was uterovaginal prolapse (81.8%). The mean duration of surgery was 61.6 min and the average blood loss was 50.1 ml. Four patients (1.2%) had intraoperative complications. Six patients (3.3%) had grade 2 or more vaginal vault prolapse at 5 year follow up. Conclusion: Vaginal hysterectomy is safe and cost effective, and should be the approach of choice for hysterectomy whenever feasible in view of its advantages and lower complication rates. It can often be safely performed even in the presence of generally accepted contraindications.
Vaginal Hysterectomy; Prolapse; Complications; Contraindications
Singh P, Chuan HH, Donsen MAC. Vaginal Hysterectomy: Analysis of Cases Performed at a Single Center Over a Five Year Period. Clin Case Rep Int. 2022; 6: 1406.