Comparison of total laparoscopic hysterectomy and laparoscopically assisted vaginal hysterectomy.
We compare the surgical results of 60 women undergoing laparoscopically assisted vaginal hysterectomy (LAVH) and 41 having total laparoscopic hysterectomy (TLH) under the indications of uterine fibroids or adenomyosis. With similar specimen weight, TLH required longer surgery duration (140.4 vs. 115.1 min; p < 0.05) than LAVH. Among women with uteri weighing <or=200 g, TLH resulted in relatively smaller blood loss with comparable operating time (115.6 vs. 116.0 min for LAVH; p > 0.05) although the TLH group had a significantly higher rate of previous abdominal surgery (57.7 vs. 20%; p < 0.05). There were no significant differences between the two groups with respect to the mean cost, length of hospital stay and rate of various complications (p > 0.05). As for sexual symptoms, dyspareunia decreased significantly post-operatively in the LAVH group (p < 0.05), but not in the TLH group. A significant reduction in the frequency of orgasms after surgery was detected in both groups (p < 0.05). In conclusion, LAVH has advantages over TLH with reduced operating time. Although it is a technical challenge, TLH can be effectively performed within reasonable time limits in selected cases. The effects on sexual function, following either LAVH or TLH, are found to be similar.
Department of Obstetrics and Gynecology, Municipal Hsiao Kang Hospital, Kaohsiung, Taiwan.
Cheng Yu
CY
Long
Jia Hong
JH
Fang
Wei Chin
WC
Chen
Jinu Huang
JH
Su
Shih Cheng
SC
Hsu
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis; D011183:Postoperative Complications; D011336:Probability; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery*