Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 11 , ISSUE 3 ( May-June, 2019 ) > List of Articles

Original Article

A Comparison of Intraoperative and Postoperative Morbidity in Women Undergoing a Nondescent Vaginal Hysterctomy by Debulking Procedures vs the Conventional Method

Garima Goel, Saroj Singh

Keywords : Intraoperative blood loss, Nondescent vaginal hysterectomy, Postoperative morbidity

Citation Information : Goel G, Singh S. A Comparison of Intraoperative and Postoperative Morbidity in Women Undergoing a Nondescent Vaginal Hysterctomy by Debulking Procedures vs the Conventional Method. J South Asian Feder Obs Gynae 2019; 11 (3):144-147.

DOI: 10.5005/jp-journals-10006-1702

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: Hysterectomy of an undescended uterus via the vaginal route (i.e., nondescent vaginal hysterectomy) has promising advantages over hysterectomy done via the abdominal route because of its lesser intraoperative and postoperative morbidity, better outcome, and patient acceptance. Performing a nondescent vaginal hysterectomy via the conventional method has certain limitations, as in the cases of uterine enlargement beyond 12 weeks, where debulking procedures are being used to reduce the bulk of the uterus to facilitate the vaginal delivery of the uterus. Materials and methods: This study was conducted in the Department of Obstetrics and Gynaecology, Sarojini Naidu Medical College, Agra from July 2017 to July 2018. An estimated 100 women underwent a hysterectomy via the debulking procedure (which were designated as the study group), and another set of 100 women underwent a nondescent vaginal hysterectomy via the conventional method (which were designated as the control group). Informed consent was obtained from all the participants. Both groups were evaluated for intraoperative time required, intraoperative blood loss, incidence of bladder and rectal injuries, postoperative sepsis, postoperative duration of catherization and mobilization, duration of postoperative intravenous fluid requirement and hospital stay, and overall morbidity. Results: It was found that overall morbidity is less in cases of NDVH done by using debulking procedures than via conventional methods. The debulking procedure may appear to be more mutilating, but, by virtue of conserving operating time and avoidance of an undue pull on the suspensory ligaments, a better postoperative recovery, lesser morbidity, and better overall acceptance of the procedure was achieved. Conclusion: It is therefore recommended that when the NDVH becomes difficult in delivering the uterus in masse, there should be no hesitation in adopting a particular debulking procedure as the situation may demand.

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