10Feb 2019


  • Junior Resident, Department of Obstetrics and Gynaecology, Amala Institute of Medical Sciences, Thrissur, Kerala-680555.
  • Associate Professor, Department of Obstetrics and Gynaecology, Amala Institute of Medical Sciences, Thrissur, Kerala-680555.
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Background: Hysterectomy is the second most common operation performed by gynaecologist. The motive to try to suit the surgical procedure to modern medicine, which aims at maximum reduction of surgical damage, has led to the rediscovery of vaginal route. Against this background, we are trying to find out if Nondescent Vaginal Hysterectomy(NDVH) has an edge over Total Abdominal Hysterectomy(TAH) for benign conditions of the uterus(size <14weeks). Method: Prospective cohort study carried out in the Department of Obstetrics and Gynaecology, Amala Institute Of Medical Sciences, Thrissur during 2016-2017. 80 patients requiring hysterectomy for benign gynaecological disorders, uterine size less than 14 weeks was included in the study, the two groups consisting of 40 cases each of NDVH and TAH respectively. The patient, after discussing the pros and cons of both the surgeries with the consultant, herself decided the route of surgery. Results: Mean operative time was comparable in both NDVH and TAH arms (98.8 ? 30.32mins vs 99.5 ? 26.69mins). Intraoperative blood loss and postoperative complications like febrile morbidity and wound infection was significantly lesser in NDVH. Pain during postoperative days 1, 2 and 3(using Visual Analog Scale) was also significantly less in NDVH with mean pain score 3.1, 2.9, 2.9 as compared to 5.00, 5.20, 4.80 in TAH group(p<0.05). Mean hospital stay was also significantly less with NDVH. Conclusion: As minimally advancing technology continues to be developed and refined, surgeons must choose the safest and best cost-effective surgical approach for the patient; and this necessitates the need for resurgence of NDVH.

  1. Singh KC, Barman SD, Rinku Sengupta. Choice of hysterectomy for benign disease, Department of Obstetrics and Gynaecology, University College of Medical Sciences, Delhi Obstet. Gynecol 2004; vol:54, July/August 2004
  2. Smriti Virmani et al. Surgical trends in hysterectomy- a comparative analysis. Indian Journal of Applied Research 2014; vol:4, December 2014
  3. Hoffman MS, Decesare S and Kalter C. Abdominal hysterectomy versus transvaginal morcellation for the removal of enlarged uteri, Am J Obstet Gynecol 1994;171:309-15.
  4. Kovac SR. Hysterectomy Outcomes in Patients with Similar Indications.? Obstet Gynecol 2000;95:787-93.
  5. Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC and Lee C. Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger than 6cm in diameter or uterus weighing at least 450g; a prospective randomized study.? Acta Obstet Gynecol Scand 2002;81(22):1132-8.
  6. Benassi, MD, T. Rossi, MD, C.T. Kaihura, MD, L. Ricci, MD, L. Bedocchi, MD, B. Galanti, MD,and E. Vadora, MD Abdominal or vaginal hysterectomy for enlarged uteri:A randomized clinical trial .Am J Obstet Gynecol 2002;187:1561-5.
  7. Harmanli OH, Gentzler CK, Byun S, Dandolu V, and Grody MHT. A comparison of abdominal and vaginal hysterectomy for the large uterus. Int J Gynecol Obstet 2004;87(1):19-23.
  8. Garry R. Comparison of hysterectomy techniques and cost benefit analysis. Clin Obstet Gynaecol.1997; 11(1) :137-148
  9. Harris W. Early complications of abdominal and vaginal hysterectomy. Obstet Gynaecol Suev 1995;50:795
  10. Sharma Nidhi. Comparative analysis of trial vaginal hysterectomy and abdominal hysterectomy. Journal of Evolution of Medical and Dental Sciences. 2015;Vol.4 Issue95,NOV.26; 16052-16056.
  11. Meltomaa SS, Makinen JI, Taalikka MO and Helenius HY. One year cohort of abdominal, vaginal, and laparoscopic hysterectomies:? complications and subjective outcomes.? J Am Coll Surg 1999;189(4):389-9
  12. Abrol Shivani, Rashid S, Jabeen F, Kaul S. Comparative analysis of non-descent vaginal hysterectomy versus total abdominal hysterectomy in benign uterine disorders. Int J Reprod Contracept ObstetGynecol2017;6:846-9.
  13. Miskry T and Magos A. Randomized, prospective, double blind comparison of abdominal and vaginal hysterectomy in women without uterovaginal prolapse. Acta Obstet Gynecol Scand 2003;82(4):351-8.

[Dhanya R Shenoy and Prameela Menon. (2019); RESURGENCE OF NONDESCENT VAGINAL HYSTERECTOMY(NDVH)-THE NEED OF THE HOUR?. Int. J. of Adv. Res. 7 (2). 179-184] (ISSN 2320-5407). www.journalijar.com

Dr. Prameela Menon
Amala institute of medical sciences


Article DOI: 10.21474/IJAR01/8475       DOI URL: http://dx.doi.org/10.21474/IJAR01/8475

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