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

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

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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

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Keywords

  • Hysterectomy, vaginal
  • Uterine diseases
  • Uterus

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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