A prospective randomised study of total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy and non-descent vaginal hysterectomy for the treatment of benign diseases of the uterus

Abstract

Aims and objectives: To compare the three techniques of hysterectomy-total laparoscopic hysterectomy (TLH), laparoscopic assisted vaginal hysterectomy (LAVH) and non-descent vaginal hysterectomy (NDVH).

Materials and methods: Ninety women with benign disease of uterus with failed medical management or not amenable to medical management were randomised into three groups for either technique of hysterectomy, thirty in each group, by the same surgeon. For each patient, intra-operative parameters including total duration of surgery, blood loss, surgical difficulty and intra-operative complications were recorded. Total hospital stay, adverse events, satisfaction rate and recuperation time was analysed and compared. Statistical analysis was done using SPSS15 software.

Results: Non-descent vaginal hysterectomy (NDVH) took least operative time and significantly lesser blood loss (p = 0.02) compared to TLH and LAVH. There was no significant difference between adverse events, recuperation time and postoperative pain between the three techniques.

Conclusions: Non-descent vaginal hysterectomy may be a preferred technique over laparoscopic hysterectomy for benign diseases of uterus where extensive pelvic dissection is not required.