Our experience on non-descent vaginal hysterectomy: a forgotten skill

Sumedha Sharma, Nidhi Gupta, Aruna Nigam
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2023 · vol. 12(5) , pp. 1332–1335 · doi:10.18203/2320-1770.ijrcog20231218 · W4367369338
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This retrospective study evaluated non-descent vaginal hysterectomy outcomes in 138 patients at a tertiary hospital, finding it feasible for uteri up to 14 weeks with common complications including febrile morbidity.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This retrospective study from a tertiary hospital evaluated outcomes of non-descent vaginal hysterectomy in women with benign indications, adequate vaginal access, no suspected adnexal pathology, and no uterine descent, using techniques such as bisection/debulking/myomectomy/slicing for larger uteri. Over one year, 138 hysterectomies were performed, most patients were parous and aged 46–50 years, and the most common indications were fibroid uterus (37%) and adenomyosis (27%). The most frequent complications were febrile morbidity (n=13) and urinary tract infection (n=9), and the authors conclude the procedure can be done up to a 14-week uterine size in the hands of a skilled surgeon, while no specific limitations are stated in the provided text. Relevance to endometriosis: adenomyosis is explicitly listed as the second most common indication for hysterectomy, though the paper’s main focus is non-descent vaginal hysterectomy technique and outcomes rather than endometriosis.

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Abstract

Background: Hysterectomy is the most commonly performed major gynecological procedure. It can be done by different routes like abdominal or vaginal or laparoscopic route. Vaginal route of hysterectomy is undoubtedly less popular these days due to inclination towards laparoscopic route by both surgeon as well as patients. Keeping this is mind we have planned this paper to share our experience of Non Descent Vaginal Hysterectomy at a tertiary level hospital. Methods: A retrospective study was conducted at the department of obstetrics and gynecology of Vardhmann Mahavir Medical College & Safdarjung hospital, New Delhi over the period of one year. All the patients undergoing non -descent vaginal hysterectomy for benign indication with adequate vaginal access, without suspected adnexal pathology, who did not have any uterine descent were included in the study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing was used to remove the uterus. Intraoperative findings and post-operative complications were recorded. Statistical analysis was done. Results: During the study period total 138 hysterectomies were performed. Most of the women were in the age group of 46 to 50 years (50%). All patients were parous. In 56% patients, uterine size was 8-10 weeks. Fibroid uterus (37%) followed by adenomyosis (27%) was the commonest indication for hysterectomy. The most common complication was febrile morbidity (n=13) followed by urinary tract infection (n=9). Conclusions: Non descent vaginal hysterectomy procedure in hand of a skilled surgeon can be done upto 14 weeks uterine size.
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Background

Hysterectomy is the most commonly performed major gynecological procedure. It can be done by different routes like abdominal or vaginal or laparoscopic route. Vaginal route of hysterectomy is undoubtedly less popular these days due to inclination towards laparoscopic route by both surgeon as well as patients. Keeping this is mind we have planned this paper to share our experience of Non Descent Vaginal Hysterectomy at a tertiary level hospital.

Methods

A retrospective study was conducted at the department of obstetrics and gynecology of Vardhmann Mahavir Medical College & Safdarjung hospital, New Delhi over the period of one year. All the patients undergoing non -descent vaginal hysterectomy for benign indication with adequate vaginal access, without suspected adnexal pathology, who did not have any uterine descent were included in the study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing was used to remove the uterus. Intraoperative findings and post-operative complications were recorded. Statistical analysis was done.

Results

During the study period total 138 hysterectomies were performed. Most of the women were in the age group of 46 to 50 years (50%). All patients were parous. In 56% patients, uterine size was 8-10 weeks. Fibroid uterus (37%) followed by adenomyosis (27%) was the commonest indication for hysterectomy. The most common complication was febrile morbidity (n=13) followed by urinary tract infection (n=9).

Conclusions

Non descent vaginal hysterectomy procedure in hand of a skilled surgeon can be done upto 14 weeks uterine size. Metrics

References

Mirza R, Abdominal Versus Vaginal Hysterectomy in Non-Descent Uterus. JK Science. 2016;18(4):206-210. Shanthi S, Usha Rani S, Arumaikannu J. Feasibility of non-descent vaginal hysterectomy (NDVH) in women with scarred uterus-our experience. Int J Clin Obs Gynaecol.2017;1(2):76-79. Sarada Murali M, Khan A. A Comparative Study of Non-descent Vaginal Hysterectomy and Laparoscopic Hysterectomy. J Obs Gynaecol India.2019;69(4):69-73. Shenoy and Menon P. Resurgence of Non-descent Vaginal Hysterectomy (Ndvh)-The Need of the Hour? Int. J. Adv. Res.7;(2):179-184. Lee SH. Comparison of vaginal hysterectomy and laparoscopic hysterectomy: a systematic review and meta-analysis. BMC Women's Health.2019;19:83. Sushil K, Antony ZK. Vaginal hysterectomy for benign nonprolapsed uterus. J Obs Gynaecol India. 2004;54(1):60-63. Goel N, Rajaram S, Ghummam S. Step by step non-descent vaginal hysterectomy. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd, 2005:66. Hefni MA, Bhaumik J. Safety and efficacy of using the Liga Sure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomized controlled trial. BJOG.2005;112:329-33. Sarkar MK, Halder A. Comparative study of abdominal versus non – descent vaginal hysterectomy in a tertiary care centre. Indian Journal of Public Health Res & Development.2020;11(7): 492-96. BC. A Comparative evaluation of Non-descent vaginal hysterectomy versus Total Abdominal hysterectomy: A hospital based case control study. JNGMC.2019;17(1):20-22. Goswami D. Non-decent vaginal hysterectomy versus total abdominal hysterectomy in fibroid uterus: a comparative study in tertiary care hospital in Uttarakhand, India. Int J Reprod Contracept Obs Gynaecol.2016;5(8):2718-22. Pranathi L. Comparative study of non-decent vaginal hysterectomy with abdominal hysterectomy. Indian Journal of Obstetrics and Gynaecology Research, January-March, 2018; 5(1):77-81.

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