Outcome of Non-descent Vaginal Hysterectomy: Comparison of Conventional and Modified Method

Background:Worldwide hysterectomy is the second most common surgery performed by the gynecologist after caesarean section. It is important that the procedure of hysterectomy for Indian population should be cost effective and with minimum duration of hospital stay. This study is aimed to compare the surgical outcomes in patients undergoing non-descent vaginal hysterectomy by conventional and modified method. Material and Methods: A prospective comparative study was conducted in a tertiary care hospital from January 2017 to December 2021. A total of 150 patients of reproductive and perimenopausal age group were operated by Non descent vaginal hysterectomy due to various benign uterine diseases. Half of the patients were operated by conventional method and the other half by modified method. The demographic characteristics, indications for surgery, surgical outcomes in theform of operative time, blood loss, uterine size, hemoglobin level on postoperative day one, postoperative pain scale, complications, and hospital stay were compared in both the groups. Results: Most common indications for hysterectomies were fibroid uterus, adenomyosis and abnormal uterine bleeding. The mean operative time in boththe group was about 45mins+5. The mean blood loss in the conventional method was about 55ml-100ml and that in the modified method it was only 30ml. Postoperative analgesia was less in modified group and postoperative hospital stay were similar in both the groups. Postoperative complications were less in the patients who underwent on descent vaginal hysterectomy by modified method. Conclusions: Non-descent vaginal hysterectomy has advantages over all other hysterectomies as a scar less surgery with very few complications and the complications can be brought further down by few modifications in the surgical procedures and thus improving the overall outcome.