open access

Vol 92, No 5 (2021)
Research paper
Published online: 2021-03-30
Get Citation

The analysis of vaginal hysterectomy results depending on the uterine size

Krzysztof Adam Pogoda1, Andrzej Malinowski1, Dominika Majchrzak-Baczmanska1, Agnieszka Wosiak2
·
Pubmed: 33844245
·
Ginekol Pol 2021;92(5):339-343.
Affiliations
  1. Clinic of Surgical, Endoscopic and Oncological Gynecology, Institute of Polish Mother's Health Center, Lodz, Poland
  2. Institute of Information Technology, Lodz University of Technology, Poland

open access

Vol 92, No 5 (2021)
ORIGINAL PAPERS Gynecology
Published online: 2021-03-30

Abstract

Objectives: Vaginal hysterectomy is one of the oldest but still rarely used minimally invasive techniques. Although new surgical methods making use of robots in laparoscopy have been introduced recently, when compared with vaginal hysterectomy, these approaches do not offer significant benefits for the patients and the doctors operating on them. The purpose of this study was a thorough analysis of vaginal removal of non-prolapsed uterus with benign pathology.
Material and methods: The analysis included data of 1148 women who underwent vaginal hysterectomy in the Clinic of Surgical, Endoscopic and Oncological Gynecology between 2002 and 2014. A group of patients operated on were assessed, and data from the surgeries were obtained paying attention to such aspects as the operating time, the evaluation of morphotic blood elements, the type of perioperative complications, and the length of postoperative hospital stay. Additionally, all vaginal hysterectomies were divided into groups and analyzed taking into consideration uterus weight.
Results: Vaginal hysterectomy was performed even in cases of earlier abdominal surgeries. The mean operating time was and 69.51 ± 28.32 minutes. The patients left hospital after 2.93 days on average. The mean uterus weight was 179.69 ± 113.54 g. What is important, the enlarged uterus was not a significant obstacle during the surgery. In case of heavy uteri of more than 580g, when the fundus of the uterus reached above the navel, the attention was drawn to the need for careful preparatory procedures, which reduced the number of perioperative complications and thus had a significant influence on the length of the operation (p = 0.0170).
Conclusions: Vaginal hysterectomy is an operating technique which is relatively easy to perform and safe for the patients because it involves a slight decrease of morphotic blood elements and a small number of mid- and postoperative complications. Vaginal hysterectomy is not a contraindication in case of large uteri, even those of more than 1000 g; however, in such cases, a longer operating time and an increased number of perioperative complications must be taken into consideration.

Abstract

Objectives: Vaginal hysterectomy is one of the oldest but still rarely used minimally invasive techniques. Although new surgical methods making use of robots in laparoscopy have been introduced recently, when compared with vaginal hysterectomy, these approaches do not offer significant benefits for the patients and the doctors operating on them. The purpose of this study was a thorough analysis of vaginal removal of non-prolapsed uterus with benign pathology.
Material and methods: The analysis included data of 1148 women who underwent vaginal hysterectomy in the Clinic of Surgical, Endoscopic and Oncological Gynecology between 2002 and 2014. A group of patients operated on were assessed, and data from the surgeries were obtained paying attention to such aspects as the operating time, the evaluation of morphotic blood elements, the type of perioperative complications, and the length of postoperative hospital stay. Additionally, all vaginal hysterectomies were divided into groups and analyzed taking into consideration uterus weight.
Results: Vaginal hysterectomy was performed even in cases of earlier abdominal surgeries. The mean operating time was and 69.51 ± 28.32 minutes. The patients left hospital after 2.93 days on average. The mean uterus weight was 179.69 ± 113.54 g. What is important, the enlarged uterus was not a significant obstacle during the surgery. In case of heavy uteri of more than 580g, when the fundus of the uterus reached above the navel, the attention was drawn to the need for careful preparatory procedures, which reduced the number of perioperative complications and thus had a significant influence on the length of the operation (p = 0.0170).
Conclusions: Vaginal hysterectomy is an operating technique which is relatively easy to perform and safe for the patients because it involves a slight decrease of morphotic blood elements and a small number of mid- and postoperative complications. Vaginal hysterectomy is not a contraindication in case of large uteri, even those of more than 1000 g; however, in such cases, a longer operating time and an increased number of perioperative complications must be taken into consideration.

Get Citation

Keywords

vaginal hysterectomy; large uterus; reducing uterine size; minimally invasive technique

About this article
Title

The analysis of vaginal hysterectomy results depending on the uterine size

Journal

Ginekologia Polska

Issue

Vol 92, No 5 (2021)

Article type

Research paper

Pages

339-343

Published online

2021-03-30

Page views

966

Article views/downloads

1072

DOI

10.5603/GP.a2021.0021

Pubmed

33844245

Bibliographic record

Ginekol Pol 2021;92(5):339-343.

Keywords

vaginal hysterectomy
large uterus
reducing uterine size
minimally invasive technique

Authors

Krzysztof Adam Pogoda
Andrzej Malinowski
Dominika Majchrzak-Baczmanska
Agnieszka Wosiak

References (10)
  1. Mohan Y, Chiu VY, Lonky NM. Size matters in planning hysterectomy approach. Womens Health (Lond). 2016; 12(4): 400–403.
  2. Hoyer-Sorensen C, Hortemo S, Lieng M. Changing the route of hysterectomy into a minimal invasive approach. ISRN Obstet Gynecol. 2013; 2013: 249357.
  3. Malinowski A, Maciołek-Blewniewska G. Dlaczego histerektomia pochwowa? Ginekol Pol. 2007; 78: 434–442.
  4. Sheth SS. Vaginal or Abdominal Hysterectomy? In: Vaginal Hysterectomy. Vaginal Hysterectomy. 2nd Edition. Jaypee Brothers, New Delhi 2014: 273–293.
  5. Malinowski A, Cieślak J. Anatomiczne aspekty pochwowej histerektomii. In: Cieślak J. ed. Zaawansowane techniki operacyjne w ginekologii- hysterektomia. LCL, Łódź 2007: 47–59.
  6. Sirota I, Tomita SA, Dabney L, et al. Overcoming barriers to vaginal hysterectomy: An analysis of perioperative outcomes. J Turk Ger Gynecol Assoc. 2019; 20(1): 8–14.
  7. Humes JC, Weir L, Keyser EA, et al. The Dying Art of Vaginal Hysterectomy: A Novel Simulation. Cureus. 2019; 11(12): e6362.
  8. Kovac SR. Clinical opinion: guidelines for hysterectomy. Am J Obstet Gynecol. 2004; 191(2): 635–640.
  9. McCracken G, Lefebvre GG. Vaginal hysterectomy: dispelling the myths. J Obstet Gynaecol Can. 2007; 29(5): 424–428.
  10. Bhadra B, Choudhury AP, Tolasaria A, et al. Non Descent Vaginal Hysterectomy (NDVH): Personal Experience in 158 Cases. Al Ameen J Med. Sc. 2011; 4(1).

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl