Clinical Analysis of Trans-vaginal Hysterectomy for 644 Large Volume, Non-prolapse Uterus

Objective: To explore the feasibility and safety of transvaginal hysterectomy (TVH) for large volume, non-prolapse uterus. Methods:Six hundred and forty-four patients underwent transvaginal hysterectomy, whose uterine volume larger than 10 gestational weeks caused by different gynecological diseases, including 474 cases of uterine myoma and 170 cases of adenomyosis. The patients were divided into 3 groups according to the size of the uterus: 10～12 gestational weeks (172cases),12～14 gestational weeks (201cases),14～16 gestational weeks (175cases), and 16 gestational weeks (96cases). Results: The success rate of TVH was 99.8% except one case turned to transabdominal surgery because of unexpected uterine sarcoma. The mean weight of removed uterus in 643 cases of TVH was 370.7 g (165～1080 g), the average operation time and the operative bleeding were 60.2 min (32～98 min) and 150.4 ml (50～305 ml) respectively. The mean post-operation vaginal discharge disappeared in 1.6 days. The mean recovery time of bowel and bladder function were 1.5 days (2～3days) and 1day, respectively. The mean times of temperature normalization and hospitalization were 3.6 days (1～5days) and 4.8 days (4～7days), respectively. Conclusions: Trans-vaginal hysterectomy for large volume, non-prolapse uterus is safe and feasible in selected patients.