Total hysterectomy for a nonprolapsed, benign uterus in women without vaginal deliveries.
OBJECTIVE
To compare the different techniques of hysterectomy for a nonprolapsed, benign uterus in women without vaginal deliveries.


METHODS
A retrospective study in a university hospital analyzed 148 total hysterectomies in women without vaginal deliveries performed from August 1991 to June 2000. Forty-four patients had had cesarean sections (29.7%), and 104 (70.3%) were nulliparous. Twenty-four patients had had abdominal myomectomies (16.2%). The vaginal route (group 1) was used for 77 patients (52%), 56 (37.8%) had laparotomies (group 2), and 15 (10.2%) had laparoscopically assisted vaginal hysterectomies (group 3).


RESULTS
The uterine weight was 275 (+/- SD 140) g in group 1, 830 (+/- SD 1620) in group 2 and 331 (+/- SD 160) in group 3. Mean operation time was 87 (+/- SD 76) minutes in group 1, 96 (+/- SD 41) in group 2 and 112 (+/- SD 56) in group 3. There was one serious complication with the vaginal route (sigmoid injury). The hospital stay was 4 (+/- SD 3.1) days in group 1, 7.1 (+/- SD 3.8) in group 2 and 4.3 (+/- SD 1.5) in group 3.


CONCLUSIONS
Vaginal hysterectomy for a nonprolapsed, benign uterus is indicated for women without vaginal deliveries and is feasible in 72% of cases in our recent experience, with a low complication rate. Training in vaginal surgery should allow safe performance of the procedure at most centers.
Chauveaud
Aurélia
A
Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92 141 Clamart, France.
de Tayrac
Renaud
R
Gervaise
Amélie
A
Anquetil
Christophe
C
Fernandez
Herve
H
D000328:Adult; D000368:Aged; D002585:Cesarean Section; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009929:Organ Size; D010298:Parity; D011336:Probability; D012189:Retrospective Studies; D016896:Treatment Outcome; D014599:Uterus / Q000033:anatomy & histology / Q000502:physiology