Non-descended Vaginal Hysterectomy—Is a Reasonable Alternative to LAVH?

Nurun Nahar Khanam, Bidisha Chakma, Saleha Begum Chowdhury, Khairun Nahar, Nusrat Rahman, Rhea Homaira
In: Journal of South Asian Federation of Obstetrics and Gynaecology · 2009 · vol. 1(1) , pp. 47–52 · doi:10.5005/jp-journals-10006-1045 · W2141900677
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Abstract

Abstract This randomized case control clinical trial has been designed to assess whether non-descended vaginal hysterectomy (NDVH) can be performed as an alternative to laparoscopic assisted vaginal hysterectomy (LAVH). The study was conducted in the Department of Gynaecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka over a period of one year. Patients admitted for hysterectomy were the study population. DUB, fibroid uterus < 12 weeks size and adenomyosis were inclusion criteria. A total of 30 patients were consecutively selected and then randomly assigned by lottery method for LAVH and NDVH. The test statistics used to analyze the data were descriptive statistics, Fisher's Exact Probability test and Mann Whitney Test. The mean age, socioeconomic condition, duration of marriage, parity, size of the uterus and indications of operation was similar in both groups. The patients of LAVH group have had significantly higher mean operation time (p < 0.001). One patient of LAVH group has got bladder injury and the operation had to be switched over to abdominal hysterectomy. The LAVH group exhibited significantly less hemoglobin level on 3rd postoperative day (p < 0.001). However, the total amount of analgesics needed was much higher in the NDVH group (p < 0.005) and the total cost of operation was significantly higher in the LAVH group (p < 0.001). No difference was observed in terms of day of discharge and day of disappearance of pain. Laparoscopically assisted technique in the filed of gynecology of the developing country is newer one. Training on the laparoscopic technique and concomitant reduction of anesthesia and surgeon charges is very much necessary to make the technique popular. Considering the operating time and expenditure the non-descended method might be a very good alternative to laparoscopic one especially in the developing country.

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