November 2016 · Volume 5 · Issue 11 Page 3915
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Sathiyakala R et al. Int J Reprod Contracept Obstet Gynecol. 2016 Nov;5(11):3915-3918
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Comparison of vaginal hysterectomy and laparoscopically assisted
vaginal hysterectomy in women with benign uterine disease:
a retrospective study
Sathiyakala Rajendran*, Suguna Srinivasan, Karnaboopathy R.
INTRODUCTION
Hysterectomy is the most commonly performed
gynaecological procedure.
1
About 70% of hysterectomies
are performed for benign conditions such as fibroid
uterus, uterine prolapse, adenomyosis, dysfunctional
uterine bleeding etc. Hysterectomy can be done by
abdominal, vaginal or laparoscopic approach.
Based on the indications for surgery, surgeon’s training
and preference, uterine size, presence or absence of
associated pelvic pathologies and patient’s choice, the
surgical route of approach is decided. Traditional vaginal
hysterectomy (VH) is commonly preferred in patients
with uterine size equivalent to or less than 12 weeks
gestation, no history of previous surgery, normal adnexa
and absence of associated pelvic pathologies. Nowadays,
with advances in laparoscopic techniques, laparoscopic
Department of Obstetrics and Gynecology, Shri Sathya Sai medical college and research institute, Ammapettai 603108
Kancheepuram, Tamilnadu, India
Received: 30 August 2016
Accepted: 28 September 2016
*Correspondence:
Dr. Sathiyakala Rajendran,
E-mail: sathya_jipmer@yahoo.co.in
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Nowadays, there is a trend in favour of (laparoscopically assisted vaginal hysterectomy) LAVH even
for patients in whom (vaginal hysterectomy) VH is feasible. Hence, this study is undertaken to compare the efficacy
of LAVH and the traditional vaginal hysterectomy for the treatment of benign uterine disease and also to find out the
advantage of LAVH over VH.
Methods: The study population consists of patients who had undergone hysterectomy for benign uterine disease
excluding prolapse of uterus. Medical records of patients who had undergone vaginal hysterectomy (50) and LAVH
(50) without any medical illness and without previous surgical history (except sterilisation) were collected. Age,
parity, indication for hysterectomy, operative time, intra operative and postoperative complications and duration of
hospital stay were noted and compared between the two groups.
Results: The mean operative time was significantly shorter in the VH group (83.7min) than in the LAVH group
(128.7 min) and the difference was statistically significant (p<0.000). Total hospital stay was significantly longer in
the VH group (7.1days) when compared to the LAVH group (4.9days) and the difference was found to be statistically
significant (p<0.000). There were no intraoperative complications noted in both the groups. There was no significant
difference in the minor postoperative complications (fever and spotting per vaginum) between the two groups.
Conclusions: This study shows lesser operative time in VH group when compared to LAVH group and there is no
added advantage in performing LAVH other than shorter hospital stay. Hence it is concluded that whenever feasible
VH should be the preferred route of hysterectomy.
Keywords: Benign uterine disease, Laparoscopically assisted vaginal hysterectomy, LAVH vs. VH, Vaginal
hysterectomy
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20163864