Non descent vaginal pan hysterectomy in benign ovarian tumour in elderly parous patients - an experience

Objectives: 1) To study the feasibility of performing and outcome of vaginal hysterectomy in uteri without any descent and associated with benign ovarian tumour. 2) To compare the outcome of vaginal hysterectomy over hysterectomy performed through abdominal route and laparoscopically. Methodology: Three hundred (300) patients requiring pan hysterectomy for benign ovarian tumours were studied within 15 years from 2002 to 2016 in Silchar Medical College, Silchar. Out of which 100 each is taken for vaginal, abdominal and laparoscopic panhysterectomy. All patients were elderly above 40 years, parous and without any uterine descent. Results: Hundred successful vaginal panhysterectomies were carried out. Seventy five (75%) of the ovarian tumour removed enmass in collapsed state (punctured and fluid drained vaginally). Adenomyosis was the commonest benign condition associated (18%). Bisection was done in 40 patients and myomectomy in 5 patients. The amount of blood loss during surgery, duration of surgery and length of hospital stay was significantly more in the abdominal hysterectomy in comparison to vaginal hysterectomy. Requirement of blood transfusion was more in abdominal group in comparison to vaginal and laparoscopic group. Conclusion: In this study it was found that the vaginal panhysterectomy can be safely performed in cases of benign ovarian tumours in non descent uterus, though it requires the expertise and experience of the surgeon.