Non Descent Vaginal Hysterectomy (NDVH): Personal Experience in 158 Cases

Aims: To report personal experience of NDVH in 158 cases. Methods: All patients requiring hysterectomy for benign gynecological disorders who did not have any uterine descent were recruited for this study. NDVH was performed in cases where the uterus was mobile, with size not exceeding 20 weeks gestation, and with adequate vaginal access. Morcellation techniques like bisection, myomectomy, wedge debulking or combinations of these were employed in bigger sized uterus. Patients not fitting the prerequisites for NDVH underwent abdominal hysterectomy. Observations: Total 198 hysterectomies were performed during the study period. Vaginal route was employed in 158 patients and abdominal in 35 cases. Out of 158 vaginal hysterectomies, 78 cases (49.4%) were in the age group of 41 to 45 years. Dysfunctional uterine bleeding was the commonest indication (60 cases, 37.9%). Morcellation techniques were employed in 126 cases (79.74%). Vaginal hysterectomy was successful in all although in one case laparoscopic help was needed for tackling infudibulopelvic hematoma. Mean operating time was 55 minutes, with average blood loss 100 ml, and hospital stay 3 days. Complications were minimal. Conclusion: Vaginal hysterectomy for non-descent large uterus is safe and feasible provided one is familiar with the morcellation techniques.