Is an enlarged fibroid uterus a contraindication for Non-Descent Vaginal Hysterectomy (NDVH)? Retrospective comparison between cohort whose uterine size ≥ 12 weeks and cohort whose uterine size less than 12 weeks underwent NDVH.

Document Type : Original Article

Authors

1 benha university

2 Benha faculty of medicine

3 Obstetrics & Gynecology Benha Faculty of Medicine Benha University Egypt

4 Obstetrics and gynecology, Benha Faculty of Medicine, Benha university

5 Teaching Hospitals Organization

6 obstetrics and gynecology, Al-Qasr Al-Aini, Cairo University Egypt

Abstract

Background: An enlarged fibroid uterus greater than 12 weeks is considered a contraindication for Non-Descent Vaginal Hysterectomy (NDVH) by most gynecologic surgeons, is this contraindication real or alleged?
Aim: to evaluate the impact of uterine size on perioperative consequences in women who underwent NDVH for benign conditions.
Patients and Methods: Of 340 women underwent NDVH, 232 women had uterine sizes up to 12 weeks (control group), and 108 women who had uterine sizes more than 12 and up to 24 weeks (index group).
Results: Both groups were similar regards menopausal, nulliparity status, number of prior vaginal birth, preoperative medical status, and American Society of Anesthesiologists grades (P>0.05), but different in percentage of women with fibroids, cervical pathology, prior Cesarean section, and virgin lower abdomen(P0.05). However, the effect of uterine size larger than 12 weeks in comparison to uterine size up to 12 weeks was significant on the subsequent outcomes total operative time (55 minutes) operative blood loss (160 ml), needs for general anesthesia, needs for debunking, needs for analgesics, decline in PO HB, and return to usual activity(P

Keywords

Benha Medical Journal
Volume 41, Issue 4
(special issue gynecology and obstetrics)
July and August 2024
Pages 136-151

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