Non decent vaginal hysterectomy: personal experience of 105 cases

Background: Objective of current study was to evaluate the feasibility of performing vaginal hysterectomy for non-prolapsed uterus as a primary route.Methods: A hospital based prospective study was conducted at department of obstetrics and gynaecology of SMS & R from 1st January 2011 to 31st August 2014. All the patients undergoing non-descent vaginal hysterectomy for benign indication, without suspected adnexal pathology were included in the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded. Results: A total of 105 cases were selected for non-descent vaginal hysterectomy. All 105 cases successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 48.6%. All patients were parous. Uterus size was <8 weeks in 72 cases and >8 weeks in 33 cases. Commonest indication was AUB (45.7%). Mean duration of surgery was 90 minutes. Mean blood loss was 205 ml. The most common complication was post –operative pain in 21.9% of cases. Febrile morbidity was present in 9.5% of cases. Blood transfusion was required in 4 cases. Average duration of hospital stay was four days.Conclusions: Vaginal hysterectomy for benign gynecological causes other than prolapse is safe and feasible, more economical and effective. For successful outcome size of uterus, size in all dimensions and location of fibroid should be taken into consideration. Today in the era of minimally invasive surgery, non-descent vaginal hysterectomy needs to be considered and seems to be a safe option.