Laparoscopic vs vaginal hysterectomy for benign pathology.
OBJECTIVE
The objective of the study was to compare length of stay, blood loss, operative time, and pain of laparoscopic and vaginal hysterectomy.


METHODS
This was a prospective, randomized, controlled comparison between vaginal (VH) and laparoscopic (LH) hysterectomy among 60 consecutive patients with a uterine volume of 300 mL or less and without uterine prolapse. Patients were followed up for 12 months.


RESULTS
The groups were significantly different for mean operative time (VH: 81 +/- 30 minutes; LH: 99 +/- 25 minutes; P = .033) and blood loss (LH: 83 +/- 57 mL; VH: 178 +/- 149 mL; P = .004). Bilateral adnexectomy was performed when preoperatively planned in 73% of cases of the vaginal arm, whereas it was always performed in the laparoscopic arm (P = .045). Postoperative pain on day 0 and the number of days of analgesic request were higher in the vaginal group (P = .023 and P = .017, respectively). LH was associated with a reduced hospital stay (LH: 2.7 +/- 0.5 days; VH: 3.2 +/- 0.6 days; P < .001).There were no differences between the groups at the follow-up.


CONCLUSIONS
Laparoscopic hysterectomy results in a shorter hospital stay, less blood loss, and less postoperative pain compared with vaginal hysterectomy.
Candiani
Massimo
M
Department of Gynecology and Obstetrics, San Paolo Hospital, University of Milan School of Medicine, Milan, Italy.
Izzo
Stefano
S
Bulfoni
Alessandro
A
Riparini
Jennifer
J
Ronzoni
Stefania
S
Marconi
Annamaria
A
D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D014591:Uterine Diseases / Q000601:surgery*; D014621:Vagina