Vaginal hysterectomy for the non-prolapsed uterus: A retrospective case review

Abstract

Objective To review the surgical outcomes of 89 cases of vaginal hysterectomy performed over a 5 year period for non prolapse. Methods A retrospective descriptive study on 89 patients who had undergone vaginal hysterectomy for non prolapsed uteri over a 5 year period in a North London University Hospital. Preoperative demographic parameters such age, BMI, ASA grade, parity, previous abdominal surgery and preoperative Hb were collected. Perioperative outcomes measured included operative time, estimated blood loss (EBL), length postoperative stay and intra and postoperative complications. Results The mean operative time (100 + 42.5 min), EBL (272 + 308 mL) and postoperative stay (38.7 + 27 h) were all calculated. Twenty one patients (23.6%) experienced either intraoperative or postoperative complications including bladder injury (1.12%), vaginal wall Injury (1.12%) and pelvic sepsis (15.7%), with three patients (3.37%) requiring blood transfusion. Eleven patients (12.4%) required hospital readmission after discharge, all for complications of pelvic infection. There was a positive correlation between uterine weight (234 + 220.6 g, range 18-1200 g), operative time (Spearman's Rank, q = 0.548 Pvalue = 2.66e-008) and EBL (q = 0.492 P-value = 9.98e-007) but no significant correlation with postoperative stay (q = 0.104; P-value = 0.333). There was no significant increase in complications in Patients with previous abdominal surgery (51.7%) and previous caesarean (13.5%). Conclusion Vaginal hysterectomy does not appear to be associated with increased perioperative morbidity in patients with enlarged uteri, previous caesarean or previous abdominal surgery.