Improved vaginal hysterectomy for non-prolapsed uterus

Objective: To assess the technique and clinical effect of improved transvaginal hysterectomy(TVH) for non-prolapsed uterus.Methods: Seventy cases of non-prolapsed uterus were performed the improved transvaginal hysterectomy(a-TVH) and the other 60 cases transabdominal hysterectomy(TAH).The outcome was compared.Results: The non-prolapsed uterus with the size of 16 weeks of gestation was safely removed by a-TAH,with no damage to the adjacent organs.For the cases with the uterus size ≤ 12 weeks of gestation,the average operation time was(66.41±19.56) min and(78.40±22.28) min in the a-TVH group and TAH group,respectively(P<0.01).The average volume of blood loss was(86.20±21.21) ml and(100.51±18.34) ml in a-TVH group and TAH group,respectively(P<0.01).For the cases with the uterus size >12 weeks of gestation,there was no significant difference in the average operation time or the average volume of blood loss between the two groups(P>0.05).In the TVH group,the anus exhaust time was(28.24 ±4.23) h and the first time to move about was(27.25±2.56) h after the operation;postoperative pain was observed in 7.14% of the patients and the incidence of fever was 5.71%;the average hospital stay was(5±1.2) d after the operation.In the TAH group,the anus exhaust time was(39.25 ±3.44) h and the first time to move about was(36.13±3.52) h after the operation;85.00% of the patients complained of postoperative pain and 25% of the patients developed fever;the average hospital stay was(7±1.3) d after the operation.The difference was significant(P<0.01).Conclusions: a-TVH is a good operative method with the advantages of less damage and quicker recovery.For cases of benign disease of the uterus,non serious pelvic adherence or bulk of the uterus ≤ 16 weeks of gestation,the TVH is the first choice.