Laparoscopically Assisted Vaginal Hysterectomy Following Previous Kidney Transplantation

Szu‐Yu Chen, Szu-Yu Chen, Su‐Cheng Huang, Su-Cheng Huang, Bor-Ching Sheu, Bor‐Ching Sheu, Daw-Yuan Chang, Daw‐Yuan Chang, Li‐Yun Chou, Li-Yun Chou, Wen-Chiung Hsu, Wen‐Chun Chang, Wen-Chun Chang
Taiwanese journal of obstetrics & gynecology · 2009 · vol. 48(3) , pp. 249–253 · doi:10.1016/s1028-4559(09)60298-9 · PMID:19797014 · W1995029517
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Laparoscopically assisted vaginal hysterectomy was safely and effectively performed in four women with symptomatic adenomyosis who had previously undergone kidney transplantation.

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Abstract

OBJECTIVE: With improvements in immunosuppression and surgical techniques, more women are undergoing kidney transplantation (KT) for management of end-stage renal disease. Location of the transplanted pelvic kidney and transplanted ureter must be taken into consideration when performing pelvic surgery. We demonstrate that laparoscopically assisted vaginal hysterectomy (LAVH) can be successfully performed in patients who had previously undergone KT. MATERIALS AND METHODS: We prospectively enrolled four patients requiring operation for symptomatic adenomyosis after KT. LAVH was performed in these cases after initial uterine artery ligation during laparoscopy. RESULTS: The median age of the patients was 44 years (range, 40-46 years) and the extirpated uterine weight was 195 g (range, 160-380 g). Intraoperatively, the median operation time was 147.5 minutes (range, 105-175 minutes) and the blood loss was 50 mL (range, 50-100 mL). There was mild pelvic adhesion in two cases. The postoperative recovery was good in all patients with oral intake, flatus passage, and ambulation within 1 day after operation. The median intramuscular meperidine requirements were 25 mg (range, 0-100 mg) and the hospital stay was 4 days (range, 3-8 days). There were no major complications in these cases except one with mild postoperative fever. CONCLUSION: LAVH may be a safe and effective treatment for treating patients with adenomyosis after KT.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Hysterectomy Kidney Transplantation Laparoscopy Uterine Artery Adult Endometriosis Female Humans Hysterectomy Length of Stay Ligation Middle Aged Postoperative Complications Postoperative Complications Prospective Studies Uterine Artery

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