Use Of Non Descent Vaginal Hysterectomy In Benign Uterine Pathology

Corresponding author Shikha Madan ,Department Of Obs & Gynaecology, PGI Rohtak. This article may be cited as: Madan S, Kumar P and Dalal M. Use Of Non Descent Vaginal Hysterectomy In Benign Uterine Pathology . Int J Com Health and Med Res 2017;3(2):80-83 Article Received: 08-08-16 Accepted On: 28-09-2016 NTRODUCTION Hysterectomy: The word is derived from the latin word Husteros Hysteros meaning Uterus. Thus, hysterectomy literally means removal of uterus through sheath (sheath meaning vagina) – Vaginal Hysterectomy.1 Traditional abdominal and vaginal hysterectomies represent the most and least invasive techniques respectively. The ease and convenience offered by a large abdominal incision have led to the preponderance of abdominal hysterectomy over the vaginal route. Laparoscopic route is associated with increased operating times and rise in the rate of intraoperative injuries.2 In older days, vaginal hysterectomy was limited to only prolapsed uterus. But with improved obstetric practices there is reduced incidence and severity of genital prolapse. Non descent vaginal hysterectomy is the removal of uterus through vagina where there is no descent of the cervix. For some time in history, such a surgical procedure was considered unacceptable.3 As the awareness of simplicity and benefits involved with the vaginal route, that the vagina is the ideal and most natural route to approach the uterus along with the availability of good anesthesia, light, better suture material, electro-surgical techniques, exploration of the uterus through the vaginal route has become more popular.4 Hence; we planned the present I Background: Traditional abdominal and vaginal hysterectomies represent the most and least invasive techniques respectively. The ease and convenience offered by a large abdominal incision have led to the preponderance of abdominal hysterectomy over the vaginal route. In older days, vaginal hysterectomy was limited to only prolapsed uterus. But with improved obstetric practices there is reduced incidence and severity of genital prolapse. Non descent vaginal hysterectomy is the removal of uterus through vagina where there is no descent of the cervix. Hence; we planned the present study to assess various factors associated with the use of non descent vaginal hysterectomy in benign uterine pathology Material and Methoed: The present study included assessment of 25 patients that required vaginal hysterectomy. The selected patients had uterine size of less than 14 weeks. Patients who had positive malignancy, endometriosis, cervix flushed to vaginal, those with large adnexal masses and the ones with uterus having severely restricted mobility were not included in the study. All cases were done under regional anesthesia, either spinal or epidural. Uterus was removed. Uterine bisection, morcellation, debulking and myomectomy were done as and when required. Vaginal hysterectomy was considered successful if it was not converted to abdominal hysterectomy. All the results were complied and assessed by SPSS software. Result: In the present study parity 3 was commonest in non descent uterus group. 25 patients underwent Non descent vaginal hysterectomy (NDVH), out of which 56% of uterus were removed intact due to normal size of the uterus. In some cases special operative techniques were required, in which bivalving was most commonly used technique. Cnclusion: NDVH was initially restricted to small size uterus, however with techniques like morcellation, bivalving and myomectomy, NDVH can be used for large size uterus and is a safe technique.