Comparison of intraoperative and postoperative outcomes of nondescent vaginal hysterectomy and total laparoscopic hysterectomy

Abstract

Introduction: Nondescent vaginal hysterectomy (NDVH) and total laparoscopic hysterectomy (TLH) are the two approaches used to perform a hysterectomy in a nonprolapsed uterus based on indication for surgery, size of the uterus, availability of types of equipment, skills of the surgeon, and patient’s preference. Each surgical approach has its own merits and demerits. Materials and Methods: A prospective and comparative study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care center from December 2018 to November 2020 to compare the intraoperative and postoperative outcomes of NDVH and TLH. A total of 80 patients (40 in NDVH and 40 in TLH group) were calculated based on the average number of hysterectomies (mainly TLH). All patients admitted to the hospital for NDVH and TLH were selected based on the selection criteria. Results: The mean age group irrespective of the route of surgery is found to be within the age group of 41–45 years. The majority of the patients who were operated on were diagnosed to have fibroids as the main cause for their complaints followed by adenomyotic changes and hyperplasia. The mean blood loss of NDVH was found less as compared to TLH but not significant as P value >0.05. The mean number of days for a hospital stay for NDVH is 4.26, whereas the hospital stay for TLH patients was found to be 4.7 days that is greater as compared with NDVH. The most common complication irrespective of the type of surgery is urinary tract infection followed by pyrexia. Conclusion: Considering the outcomes and cost-effectiveness of both routes of surgery, it is found that nondescending vaginal hysterectomy is more advantageous over total laparoscopic hysterectomy.

Keywords

• hysterectomy
• nondescent vaginal hysterectomy
• total laparoscopic hysterectomy