Vaginal hysterectomy in nulliparous women without prolapse: a prospective comparative study.
OBJECTIVE
To compare vaginal hysterectomy success and complication rates in nulliparous and primiparous or multiparous women.


METHODS
A comparative prospective study.


METHODS
Department of Gynaecology, La Conception Hospital, Marseille, France.


METHODS
Three hundred and forty-five consecutive patients without genital prolapse requiring hysterectomy for benign conditions and without previous pelvic surgery or caesareans were treated prospectively by vaginal hysterectomy. Fifty-two patients were nulliparous and 293 were primiparous or multiparous.


METHODS
Data of patients were collected prospectively.


METHODS
Operative time, length of hospital stay, oophorectomy, conversion to laparotomy, intra- and post-operative complications.


RESULTS
The mean operative time was significantly longer in nulliparous patients [95 (55.2) vs 79.9 (34.9) minutes, P < 0.01]. The overall complication rate was significantly higher [7/52 (13.46%) vs 13/293 (4.44%), P = 0.02, RR = 3.03 (1.27-7.23)] as was the haemorrhage rate in nulliparous compared with the primiparous and multiparous women [4/52 (7.69%) vs 5/293 (1.7%), P = 0.03, RR = 4.51 (1.25-16.23)]. Vaginal hysterectomy was successfully performed in 96.2% (50/52) of the nulliparous and 99.7% (292/293) of the parous patients [P = 0.06, RR = 1.04 (0.98-1.09)].


CONCLUSIONS
The success rate of vaginal hysterectomy in nulliparous women is high. However, the risk of complications seems higher than in the parous women. Laparoscopy assisted vaginal hysterectomy in nulliparous women needs further investigations.
Agostini
Aubert
A
Department of Obstetrics and Gynecology, La Conception University Hospital, Marseille, France.
Bretelle
Florence
F
Cravello
Ludovic
L
Maisonneuve
Anne Sophie
AS
Roger
Valérie
V
Blanc
Bernard
B
D015992:Body Mass Index; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods; D010298:Parity; D011446:Prospective Studies