Non-descent Vaginal Hysterectomy Research Articles

The effects of vault drainage through foley’s catheter on post-operative morbidity after non-descent vaginal hysterectomy

The effects of vault drainage through foley’s catheter on post-operative morbidity after non-descent vaginal hysterectomy

Comparative Analysis of Total Laparoscopic Hysterectomy Versus Non-descent Vaginal Hysterectomy for Benign Uterine Pathologies in Women: A Systematic Review.

Hysterectomy, which can be conducted through abdominal or vaginal routes, is one of the most common gynecological procedures performed worldwide. When the patient is not able to undergo a vaginal hysterectomy due to contraindications involving a narrow pelvis or endometriosis and technical difficulties, laparoscopic removal of the uterus is the recommended method over abdominal hysterectomy. Additionally, the type of surgery depends on the expertise of the surgeon. Therefore, this systematic review aimed to evaluate different measures related to total laparoscopic (TLH) versus non-descent vaginal hysterectomy (NDVH) in women with benign uterine pathologies. ScienceDirect, PubMed, and Google Scholar databases were searched from 2019 to 2023 for a literature review using keywords including "Non-descent Vaginal Hysterectomy," AND "Total Laparoscopic Hysterectomy," AND "Benign Uterine Pathologies." This systematic review includes five studies based on the selection criteria. The data were extracted and a quality assessment of the studies was performed. The review concluded that NDVH has an advantage over TLH as a scarless surgery performed in a very short period and with minimum blood loss with fewer complications and in terms of cost-effectiveness. However, the postoperative parameters and satisfaction with the TLH technique were better than the NDVH technique, but the procedure was much more time-consuming and needed laparoscopic surgical expertise. The duration of hospitalization in NDVH and TLH was nearly the same. Furthermore, both techniques could be employed for salpingo-oophorectomy or when there are adnexal masses and adhesions present; however, TLH may be the best course of action.

Diagnosis Based Technique of Hysterectomy: Comparison among Laparoscopic and Nondescent Vaginal Hysterectomy

Diagnosis Based Technique of Hysterectomy: Comparison among Laparoscopic and Nondescent Vaginal Hysterectomy

Non-descent vaginal hysterectomies: a brief report

Non-descent vaginal hysterectomies: a brief report

A review of vaginal hysterectomies in the gynaecology department of a tertiary care hospital.

This retrospective cohort study analysed the trends and complications of vaginal hysterectomy conducted at Services Hospital, Lahore, from January 1, 2015 to December 31, 2020. Demographics, indications, surgery duration, complications (haemorrhage, urological or rectal problems, infection), and hospital stay were recorded. Out of 819 hysterectomies performed for benign gynaecological conditions, 112 (13.68%) were vaginal hysterectomies. Non-descent vaginal hysterectomy (NDVH) accounted for 33(29.46%) and uterine prolapse for 79(70.53%) of the cases. Mean age was 52.35±8.74 years, parity was 5.01±1.32, intraoperative haemorrhage was 796.87±450.1 ml, surgery duration was 48.61±12.28 minutes, and hospital stay was 2.58±0.41 days. Complications occurred in 19(16.97%) of the cases, while 93(83.03%) cases had no complications. Outcomes were comparable between NDVH and vaginal hysterectomy for prolapse (p=0.552). This indicates that vaginal hysterectomy is a safe procedure with minimal complications and quick recovery for uterine prolapse and non-descent uterus. However, a declining trend was observed over the study period.

Is an enlarged fibroid uterus a contraindication for Non-Descent Vaginal Hysterectomy (NDVH)? Retrospective comparison between cohort whose uterine size ≥ 12 weeks and cohort whose uterine size less than 12 weeks underwent NDVH.

Is an enlarged fibroid uterus a contraindication for Non-Descent Vaginal Hysterectomy (NDVH)? Retrospective comparison between cohort whose uterine size ≥ 12 weeks and cohort whose uterine size less than 12 weeks underwent NDVH.

Outcomes of Hysterectomy in Women with Prior Cesarean Section: Retrospective Analysis of Non-Descent Vaginal Hysterectomy (NDVH) Versus Abdominal Hysterectomy (TAH) in Benha University Hospital

Outcomes of Hysterectomy in Women with Prior Cesarean Section: Retrospective Analysis of Non-Descent Vaginal Hysterectomy (NDVH) Versus Abdominal Hysterectomy (TAH) in Benha University Hospital

A comparative clinical study between laparoscopic-assisted vaginal hysterectomy versus nondescent vaginal hysterectomy in benign pathological conditions

Abstract Background: The need of hour is an ideal hysterectomy surgery which has shorter operative time and shorter duration of hospital stay, early resumption to work, avoidance of disfiguring scar on abdomen, and less postoperative morbidities. Nondescent vaginal hysterectomy (NDVH) and laparoscopic-assisted vaginal hysterectomy (LAVH) are both minimally invasive surgeries with more benefits than total abdominal hysterectomy. Objective: To compare NDVH and LAVH in terms of operating time for surgery, intraoperative blood loss, intraoperative, and postoperative complications. Materials and Methods: A hospital-based prospective comparative study was carried out among 50 cases requiring hysterectomy. Detailed history was collected and thorough examination was conducted in 25 women who underwent LAVH and 25 women who underwent NDVH as per the standard operating guidelines. Parameters such as blood loss, duration of surgery, duration of hospital stay, intraoperative and postoperative complications, pain score, and time taken for ambulation were compared in the two groups. Results: Both the groups were comparable in terms of age, body mass index, comorbidities present, size of the uterus, past history of surgery, and diagnosis (P > 0.01). Both the groups were comparable for intraoperative or postoperative complications (P > 0.01). The mean blood loss, time taken for ambulation, pain score, and duration of hospital stay were significantly lesser (P < 0.01) in the LAVH group compared to the NDVH group even though the duration of surgery was significantly (P < 0.01) more in this group. Conclusion: We conclude that LAVH has more advantages over NDVH and should be incorporated in selected patients requiring hysterectomy.

Salpingo-Oophorectomy During Non-Descent Vaginal Hysterectomy Using the Paily Vaginal Oophorectomy Clamp

We conducted a 6-year prospective surgical case series study at a tertiary care centre in South India to evaluate the safety and efficacy of the novel Paily Vaginal Oophorectomy Clamp and its unique application technique during non-descent vaginal hysterectomy requiring salpingo-oophorectomy. The Paily Vaginal Oophorectomy Clamp’s reversed blade design allows direct and secure grasping of the infundibulopelvic ligament as there is no intervening tissue near the joint, reducing the risk of slippage. In contrast, while using conventional clamps such as Heaney's, infundibulopelvic slippage occurs due to the presence of tissue between blades near the joint. A demonstration video is provided (Video).

Retrospective Comparison of Non-descent Vaginal Hysterectomy and Total Laparoscopic Hysterectomy for Bulky Uterine Fibroids

Retrospective Comparison of Non-descent Vaginal Hysterectomy and Total Laparoscopic Hysterectomy for Bulky Uterine Fibroids

Comparative Analysis of Non-Descent Vaginal Hysterectomy in Nulliparous and Parous Women: Insights from a Retrospective Study

Comparative Analysis of Non-Descent Vaginal Hysterectomy in Nulliparous and Parous Women: Insights from a Retrospective Study

A Comparative Study of Patient Outcome in Women Undergoing Abdominal Vs Non-Descent Vaginal Hysterectomy

A Comparative Study of Patient Outcome in Women Undergoing Abdominal Vs Non-Descent Vaginal Hysterectomy

NON-DESCENT VAGINAL HYSTERECTOMY USING BIPOLAR VESSEL SEALING SYSTEM VERSUS TOTAL LAPAROSCOPIC HYSTERECTOMY FOR BENIGN DISEASES OF UTERUS: A PROSPECTIVE INTERVENTIONAL STUDY

Objective: The objective of the study was to compare the surgical outcomes of non-descent vaginal hysterectomy (NDVH) using bipolar vessel sealing system and total laparoscopic hysterectomy (TLH) with reference to intraoperative time, intraoperative blood loss, and post-operative pain. Methods: The study was conducted on 100 patients who required hysterectomy for benign diseases of uterus and was fit to undergo both modalities of surgery (TLH/NDVH). 50 patients that underwent TLH and 50 patients that underwent NDVH with BipBIPVSS were part of Study Group. Results: The mean intraoperative time taken in performing NDVH using Bipolar BIPVSS (28.06 min) was significantly less than the mean time taken in performing TLH (92.62 min). The intraoperative blood loss in NDVH with BIPVSS was 41.70 mL and TLH was 89.24 mL. The post-operative pain in both the study group was not statistically significant as both the groups had similar experience and p>0.05. Post-operative major complication of bleeding in ovarian artery and hemoperitoneum was observed in a patient of NDVH with BIPVSS while one case of thermal rectal injury and one case of bladder injury were observed in TLH group. Conclusion: The route and procedure of hysterectomy will depend on various factors; however, NDVH with BIPVSS has certain advantage over TLH as it takes lesser times, lesser blood loss and gives similar pain experience if not better than TLH.

NON DESCENT VAGINAL HYSTERECTOMY IN BENIGN UTERINE CONDITIONS -RETROSPECTIVE ANALYSIS

Introduction: Hysterectomy is commonly performed gynaecological surgery for various indications. It can be done by abdominal, vaginal or laproscopically. NDVH is removal of the uterus through vaginal route without uterine descent. Aim: To study the ability of nondescent vaginal hysterectomy done for benign uterine conditions. Objectives: 1. To study the intraoperative and post-operative complications encountered during NDVH and their management. 2. To assess the operative time, intraoperative blood loss, and post-operative hospital stay. Material And Methods: 65 cases were analysed from OT records. All relavent information regarding menstrual history, obstetric history and details regarding clinical examination was collected from casesheets from record room and cases were analysed regarding indication for hysterectomy, size of uterus, mode of delivery(NVD,LSCS). Intraoperative and post-operative complications were analysed. Duration of postoperative hospital stay was analysed. Patients were asked to come for follow up 15 days after discharge. Results: 90.7%(59) of NDVH cases were discharged without complications suggesting low morbidity associated with the procedure. Hemorrhage requiring blood transfusion was found in 4.6 % of cases. conversion to emergency laparotomy due to bladder injury is seen in 1.5% cases. Conversion to TAH due to difculty in opening pouch of douglas is seen in 3.07%. Post-operative complications such as vaginal discharge seen in 7.6%, fever was seen in 6 % of cases. 80% of patients postoperative hospital stay was 3 to 4 days. Conclusion: The present analysis conclude that patients requiring hysterectomy for benign non prolapsed cases can be offered option of non descent vaginal hysterectomy which has quicker recovery, shorter hospital stay and lesser postoperative complications.

Conventional Technique with Modernisation: Non-Descent Vaginal Hysterectomy with Removal of Largest Ovarian Tumor Through Same Route in Tribal Belt of India

Various surgical approaches such as vaginal, abdominal, laparoscopic and robotic assisted laparoscopic hysterectomy are considered for hysterectomy and risk factors and associated morbidity determines the selection of the surgical procedure. The available healthcare infrastructure also determines that surgical approach considered for the patients and needs some customisation. In this case report, the case of Non-Descent Vaginal Hysterectomy along with the right sided & left sided salpingo-oophorectomy in rural tribal belt tertiary healthcare center in Dahod, Gujrat, India is reported. Total weight of the tumor removed measured 6.5Kg out of that 6.1Kg was fluid and 400 Gram solid component. On histopathology report confirmed serous cystadenoma. There was no stitch, no scar performed, and this total vaginal surgery was successful.

A Comparative Study of Nondescent Vaginal Hysterectomy versus Total Abdominal Hysterectomy

Background: Hysterectomy is the most common operation performed for benign uterine conditions. It can be done through abdominal, vaginal and laparoscopic routes 1,2.The American college of Obstetricians and Gynaecologists recommends the vaginal approach as the route of choice of hysterectomy for benign disease whenever feasible 9 .Laparoscopic hysterectomy is a preferable alternative to open abdominal hysterectomy for those patients in whom vaginal hysterectomy is not indicated or feasible. Objective(S): To compare the surgical outcome of total abdominal hysterectomy (TAH) and non-descend vaginal hysterectomy (NDVH). Methods: This is a cross sectional and comparative study that was conducted from January 2014 to December 2015 in Obstetrics and Gynaecology Department of Sylhet Shaheed Shamsuddin Ahmed Hospital, Sylhet. A Total of 120 patients with benign gynaecological disorder who underwent hysterectomy were included. Among them 60 cases underwent NDVH and 60 cases underwent TAH for similar indication. Main Outcome measures are: i) Duration of operation (min) ii) intra and post-operative complications iii) blood loss (ml) during operation iv) Analgesic requirements v) post-operative hospital stay. Results: Most of the patients in both NDVH and TAH belonged to age group of 41-50 years. Majority of them were multiparousin both the groups. Medical co morbidities were Diabetes mellitus, Hypertension, Hypothyroidism and most common surgical co morbidities were history of lower segment cesarean section (LSCS), bilateral tubal ligation, laparotomy for benign ovarian pathology. Common indication for hysterectomy in NDVH was abnormal uterine bleeding (AUB) (37%) and in TAH was (18%), fibroid uterus 35% cases in NDVH and 37% in TAH. Mean operative time of NDVH group was 51.08±12.59 minutes while that of women in TAH group was 69.25±11.12 minutes. This difference was found to be statistically significant (p<0.05 when df 118). The mean blood loss in NDVH group was 61.08±18.82 ml while in TAH group was 105.50±38.42 ml, this is also statistically significant (p<0.05). Analgesic required in NDVH group 5.91±0.97 doses and in TAH was11.58±2.67 doses which is statistically significant(p<0.05).11(18%) patients developed wound infection in TAH group, but none of the patients of NDVH group developed wound infection which is significant. Post-operative hospital stay in NDVH group was 3.02±1.43 days and those in TAH group was 7.7±3.40 days this is also statistically significant. Conclusions: NDVH is safe, feasible and effective procedure and associated with less blood loss during surgery, decrease operative time, less intra-operative and post-operative complications with shorter hospital stay as compared total abdominal hysterectomy. Hence NDVH is a better option for females requiring hysterectomy for benign conditions.

Personal experience of Non Descent Vaginal Hysterectomy (NDVH) in a District Hospital - A Study of 60 cases.

Objective(S): To share our experience and explore the safety & feasibility of NDVH in 60 cases. Methods: This prospective observational study was conducted from Jan 2016 to Dec 2017 in Obstetrics and Gynaecology Department of Sylhet shaheed Shamsuddin Ahmed Hospital, Sylhet. Sixty patients requiring hysterectomy for benign nonprolapsed gynaecological disorders were the target population. Prerequisite for non-descend vaginal hysterectomy were uterine size not exceeding 20 weeks, adequate vaginal access with uterine mobility. Main outcome measures were i) Procedures of removal of large uterus ii) Time taken to complete the operation iii) Blood loss during operation iv) Postoperative hospital stay. v) Postoperative complications. Results: Vaginal hysterectomy was completed successfully in 100% cases. All patients were multiparous and in 41-45 years age group (37%). Commonest indication was AUB (37%), Second indication was fibroid uterus (35%) and next indication was adenomyosis (13%). In most of the case uterus was 10-12 weeks size (37%), in 28% cases uterine size was less than 8 weeks, 14-16 weeks size in 27% cases and uterus was more than 16 weeks size in 8% cases. Morcellation techniques like bisection, myomectomy, wedge resection and debulking were done to remove bigger sized uterus. Mean operating time was 45 minutes. Mean blood loss was 60ml. Average hospital stay was 3 day. Complications were minimum which included UTI and febrile morbidity. At 12 weeks postoperative follow up 72% patient had no adverse complain though 18% cases was drop out. Conclusions: Vaginal hysterectomy is safe feasible, scarless and patient friendly approach for benign gynaecological disorders other than prolapsed uterus. In this era of minimally invasive surgery, non-descend vaginal hysterectomy is to be considered as a safe option.

Non-Descent Vaginal Hysterectomy (Ndvh): A Promising Surgical Technique in Benign Uterine Disorders

Background: Hysterectomy, one of the most common gynaecological surgeries performed around the world, has many techniques including abdominal, vaginal, laparoscopic and robotic. The Vaginal technique which was introduced and performed eras back has been less successful due to lack of experience and eagerness among gynaecologists because of a misconception that the abdominal route is safer and is easier. Aims and Objectives: Evaluation of most efficient and suitable route of hysterectomy.comparison between intraoperative and postoperative complications in non descent vaginal hysterectomy and abdominal hysterectomy. Materials and Methods: This retrospective study was conducted during the period from October 2020 to December 2021, it studied 60 women who underwent hysterectomy for benign uterine disorder at Khemchand Jain Hospital, Sagar, out of which 30 women underwent non descent vaginal hysterectomy and 30 women underwent total abdominal hysterectomy. Result: Baseline characteristics were similar between the two groups with no intraoperative complications in either. Regarding operation duration, intraoperative blood loss, post-operative pain, post-operative blood transfusion, mobilization in post-operative periods, post-operative wounds infection, febrile morbidity, duration of hospitality stay, P-value was significant in vaginal hysterectomy when compared to abdominal hysterectomy. Regarding post-operative systematic infection, P-value was not significant. None of the cases in the vaginal group were converted to abdominal route and none of the cases in the whole study group underwent relaparotomy. Conclusion: The study concludes that patients requiring hysterectomy for benign non prolapse cases may be given the option of vaginal hysterectomy because it has quicker recovery, shorter hospitalization, lesser operative and post-operative morbidity compared to abdominal route.

A Comparative Analysis of Nondescent Vaginal Hysterectomy, Laparoscopy-Assisted Vaginal Hysterectomy, and Total Laparoscopic Hysterectomy for Benign Uterine Diseases at a Rural Tertiary Care Center.

Objectives:The aim of this study was to compare operative data and postoperative complications among nondescent vaginal hysterectomy (NDVH), laparoscopy-assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) at a rural tertiary care center.Materials and Methods:This is a prospective analytical study, of 145 hysterectomies for benign conditions with or without salpingo-oophorectomy in women from 30 to 60 years, over 3 years from January 2016 to December 2019, with 60 cases of NDVH, 46 cases of LAVH, and 39 cases of TLH. The three groups were compared intraoperatively in terms of blood loss, operating time, and intraoperative complications and postoperative complications and postoperative duration of hospital stay.Results:There was no significant difference between the three groups in terms of age, parity, body mass index, and indications for hysterectomies. The mean operative time was significantly shorter (P = 0.000) in the NDVH group (54.67 ± 15.67 min) as compared to the LAVH (102.45 ± 10.53 min) and TLH (126.79 ± 8.7 min) groups. Intraoperative blood loss was greater (P = 0.000) in the TLH group (111.025 mL ± 20.8) as compared to the NDVH (59.50 mL ± 16.7) and LAVH (91.85 mL ± 10.66) groups. The intraoperative complications and postoperative complications were higher in the TLH group as compared to the LAVH and NDVH groups. The duration of hospital stay was almost similar in all the groups.Conclusion:NDVH may be the preferred approach for experienced surgeons, as it is less time-consuming, has a small amount of blood loss, and is a scarless surgery, whereas LAVH and TLH may be the preferred approaches in the cases of presence of adnexal masses and adhesions or whenever salpingo-oophorectomy is indicated.

Non-descent vaginal hysterectomy surgery associated with less complications and good prognosis

Background: Removal of the uterus through vagina when performed in a case without uterine descent or prolapse is known as “non-descent vaginal hysterectomy” or NDVH. Vaginal route is preferred as compared to laparoscopic and abdominal methods. The advantages of vaginal hysterectomy being fewer complications, less post-operative stay, cost effective, and useful in bulky uterus. Aims and Objectives: The aims of the study were as follows: (1) To study the intraoperative and post-operative complications encountered during NDVH and their management. (2) To assess the intraoperative blood loss, the operative time, and post-operative hospital stay. (3) To study and check the feasibility of vaginal route as the primary route for all hysterectomies in the absence of uterine prolapse. Materials and Methods: A total of 50 patients were included in the study. Detailed history was taken including obstetric history and menstrual history and clinical examination was performed. After taking written, informed consent and doing proper pre-operative preparation, the patient was posted for NDVH. Post-operative complications were noted. Patients were asked to come for follow-up after 15 days. Results: In 92% of cases operated, no intraoperative complications were found suggesting low morbidity associated with the procedure. Hemorrhage requiring blood transfusion was found in 4% of cases. Average operative time was 61.2 ± 27.89 min, average blood loss was 170 ± 81.44 ml, and average hospital stay was 5.94 ± 4.95 days. On histopathological examination, 40% were having leiomyoma and dysfunctional uterine bleeding was seen in 22% of cases. Pain was the most common complication seen in 30% of cases while vaginal discharge was seen in just 4% of cases. About 80% of patients were discharged on post-operative day 5. Conclusion: In 92% of NDVH cases, no intraoperative complications were found suggesting low morbidity associated with the procedure. The post-operative hospital stay was restricted to 5 days in 80% of cases which indicates early discharge of the patient. Post-operative complications such as vaginal discharge and fever were seen only in 4% of cases. NDVH should, therefore, be considered as the primary route for all hysterectomies unless contraindicated in the absence of prolapse.