title: Evaluation of the outcomes of laparoscopic hysterectomy for normal and enlarged uterus (>280 g).
abstract: OBJECTIVE
  The aim of this study was to evaluate intraoperative and postoperative outcomes of laparoscopic hysterectomy (LH) with routine intraoperative cystoscopy (CYS) for enlarged uterus (>280 g).
  
  
  METHODS
  The patients, who underwent LH procedure in the Department of Obstetrics and Gynecology in Düzce University Faculty of Medicine between July 2012 and July 2013, were included in this study. Perioperative outcomes were compared between patients with and without enlarged uterus.
  
  
  RESULTS
  Uterus weight of the operated patients ranges between 38 and 700 g. Mean uterus weight was 196.40 ± 142.32 g. Although we found longer operation time (148.75 ± 32.37 vs. 128.28 ± 27.58) and higher delta hemoglobin (2.98 ± 3.09 vs. 1.61 ± 1.29) in patients with enlarged uterus undergoing LH, these findings were not statistically significant (p = 0.077 and 0.058). No significant difference was found between the two groups in terms of need for insertion of pelvic drainage (p = 0.664), duration of bladder catheterization (p = 0.673), time of first postoperative flatus (p = 0.509) and the duration of hospitalization (p = 0.844). None of the patients had postoperative fever. The two groups were not significantly different in terms of postoperative body temperature (p = 0.736). In normal uterus group, 1 patient developed ureterovaginal fistula and 1 patient required re-operation. No major complication was observed in large uterus group.
  
  
  CONCLUSIONS
  In our study, we compared the outcomes of LH in patients with large uterus measuring up to 700 g. and patients with normal uterus, and we achieved successful results by making minor changes in the operation technique and performing diagnostic CYS at the end of the operation.
authors.affiliation: Department of Obstetrics and Gynaecology, Düzce University Faculty of Medicine, 81000, Konuralp, Düzce, Turkey, draliyavuzcan@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Yavuzcan
authors.forename: Mete
authors.initials: M
authors.lastname: Cağlar
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ustün
authors.forename: Serdar
authors.initials: S
authors.lastname: Dilbaz
authors.forename: Selahattin
authors.initials: S
authors.lastname: Kumru
mesh_terms: D000328:Adult; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D011183:Postoperative Complications; D014599:Uterus / Q000473:pathology* / Q000601:surgery*
chemical_list: D006454:Hemoglobins