Morbidity of vaginal hysterectomy for benign tumors as a function of uterine weight

Bruno Deval, Arash Rafii Tabrizi, David Soriano, Emmanuel Samain, Michel Levardon, Emile Daraï

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal hysterectomy. STUDY DESIGN: A prospective study of vaginal hysterectomy was carried out in women with benign uterine tumors. The only exclusion criteria were a suspected adnexal mass, a very narrow vagina and an immobile uterus. The women were stratified into 3 groups according to uterine weight. The groups were compared as regards indications, operative time, complication rates, analgesia requirements and postoperative recovery. RESULTS: A total of 214 women underwent vaginal hysterectomy: group 1, n = 114, uteri < 180 g; group 2, n = 73, uteri 180-500 g; group 3, n = 27, uteri > 500 g (maximum 1,350 g). The groups differed with respect to mean age (P=.003) and menopausal status (P=.002) but not gravidity, parity, previous pelvic surgery or preoperative hemoglobin levels. Concerning the indications for hysterectomy, only the incidence of pelvic compression differed between the groups (P =.04). There was no difference in the frequency of concomitant surgical procedures (e.g., adnexectomy) between the groups. Morcellation rate was 30% in group 1, 73% in group 2 and 100% in group 3. The overall complication rate was not significantly different between the groups: 20.1%, 15.0% and 22.2%, respectively. The only major complication was an injury to the infundibulopelvic ligament in a group 1 patient. Operative time increased significantly with uterine weight (82±35.4, 91.8±35.4 and 94.8±36.5 minutes, respectively; P=.01). There were no significant differences between the groups as regards perioperative hemoglobin loss, analgesia requirements, time to flatus and stool return or length of hospital stay. CONCLUSION: Vaginal hysterectomy can be performed successfully even in the case of greatly enlarged uteri; nulliparity and a history of pelvic surgery are not absolute contraindications.

Original languageEnglish
Pages (from-to)435-440
Number of pages6
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume48
Issue number6
Publication statusPublished - 1 Jun 2003
Externally publishedYes

Fingerprint

Vaginal Hysterectomy
Uterus
Morbidity
Weights and Measures
Operative Time
Parity
Analgesia
Length of Stay
Neoplasms
Hemoglobins
Gravidity
Flatulence
Vagina
Hysterectomy
Ligaments
Prospective Studies
Incidence
Wounds and Injuries

Keywords

  • Hysterectomy, vaginal
  • Uterine diseases
  • Uterus

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Morbidity of vaginal hysterectomy for benign tumors as a function of uterine weight. / Deval, Bruno; Tabrizi, Arash Rafii; Soriano, David; Samain, Emmanuel; Levardon, Michel; Daraï, Emile.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 48, No. 6, 01.06.2003, p. 435-440.

Research output: Contribution to journalArticle

Deval, Bruno ; Tabrizi, Arash Rafii ; Soriano, David ; Samain, Emmanuel ; Levardon, Michel ; Daraï, Emile. / Morbidity of vaginal hysterectomy for benign tumors as a function of uterine weight. In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 2003 ; Vol. 48, No. 6. pp. 435-440.
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AU - Daraï, Emile

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AB - OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal hysterectomy. STUDY DESIGN: A prospective study of vaginal hysterectomy was carried out in women with benign uterine tumors. The only exclusion criteria were a suspected adnexal mass, a very narrow vagina and an immobile uterus. The women were stratified into 3 groups according to uterine weight. The groups were compared as regards indications, operative time, complication rates, analgesia requirements and postoperative recovery. RESULTS: A total of 214 women underwent vaginal hysterectomy: group 1, n = 114, uteri < 180 g; group 2, n = 73, uteri 180-500 g; group 3, n = 27, uteri > 500 g (maximum 1,350 g). The groups differed with respect to mean age (P=.003) and menopausal status (P=.002) but not gravidity, parity, previous pelvic surgery or preoperative hemoglobin levels. Concerning the indications for hysterectomy, only the incidence of pelvic compression differed between the groups (P =.04). There was no difference in the frequency of concomitant surgical procedures (e.g., adnexectomy) between the groups. Morcellation rate was 30% in group 1, 73% in group 2 and 100% in group 3. The overall complication rate was not significantly different between the groups: 20.1%, 15.0% and 22.2%, respectively. The only major complication was an injury to the infundibulopelvic ligament in a group 1 patient. Operative time increased significantly with uterine weight (82±35.4, 91.8±35.4 and 94.8±36.5 minutes, respectively; P=.01). There were no significant differences between the groups as regards perioperative hemoglobin loss, analgesia requirements, time to flatus and stool return or length of hospital stay. CONCLUSION: Vaginal hysterectomy can be performed successfully even in the case of greatly enlarged uteri; nulliparity and a history of pelvic surgery are not absolute contraindications.

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