Clinical Analysis of Transvaginal Hysterectomy for 483 Cases Large Non-prolapsis Uteruses

Objective:To explore the feasibility of transvaginal hysterectomy(TVH)for large uterus.Methods:Four hundred and eighty-three patients underwent transvaginal hysterectomy,each of them with a uterus larger than 10 weeks pregnant size because of different gynecological diseases,including 368 cases of uterine myoma and 115 cases of adenomyosis.The patients were divided into 4 groups according to the size of the uterus:10～12 weeks pregnant size(127 cases),12～14weeks pregnant size(151 cases),14～16 weeks pregnant size(130 cases)and 16 weeks pregnant size(75 cases).The influence of uterine size on the difficulty of operation was studied.Results:The success rate was 99.8% for TVH,one patient was turned to open surgery because of unexpected uterine sarcoma.The mean weight of 482 removed uteruses was 369.7g(166～1080g).The average operation time and intra-operative bleeding were 62.2min(35～98min)and 156.4ml(50～305ml)respectively.Post-operation vaginal discharge disappeared in 1.6 days.The time of bowel and bladder function resume were 1.5 days(2～3 days)and 1 day respectively.The mean time of temperature normalization and hospitalization were 3.6 days(1～5 days)and 4.8 days(4～7 days)respectively.Conclusion:Transvaginal hysterectomy for large uterus is safe and feasible in selected patients.