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. 2022 Aug 5;11(3):150-154.
doi: 10.4103/gmit.gmit_118_21. eCollection 2022 Jul-Sep.

Risk Factors Associated with Perineal and Vaginal Lacerations and Vaginal Removal in Total Laparoscopic Hysterectomy

Kenro Chikazawa  1 , Ken Imai  1 , Hiroyoshi Ko  1 , Naoki Ichi  1 , Masahiro Misawa  1 , Tomoyuki Kuwata  1
Affiliations

Risk Factors Associated with Perineal and Vaginal Lacerations and Vaginal Removal in Total Laparoscopic Hysterectomy

Kenro Chikazawa et al. Gynecol Minim Invasive Ther. .

Abstract

Objectives: This study aimed to identify risk factors associated with perineal and vaginal lacerations related to vaginal removal during total laparoscopic hysterectomy (TLH).

Materials and methods: We retrospectively assessed 134 patients who underwent TLH, of whom 44 (32.8%) had vaginal lacerations.

Results: Univariate analysis revealed that for patients with myomas and adenomyosis, gonadotropin-releasing hormone agonist use and myomas with a transverse diameter of ≥5 cm were significant risk factors, while multiparity (vaginal delivery) was a protective factor for perineal and vaginal lacerations. Moreover, multivariate analysis indicated that multiparity was the only statistically significant protective factor. For cervical intraepithelial neoplasia, endometrial cancer, and endometrial hyperplasia, only a uterine transverse diameter of ≥5 cm was a significant risk factor for perineal or vaginal lacerations.

Conclusion: For patients with large myomas, multiple vaginal delivery was a protective factor, and in patients with normal-sized uteri, a uterine transverse diameter of ≥5 cm was a risk factor for perineal or vaginal lacerations.

Keywords: Hysterectomy; laparoscopic surgery; morcellation; perineal laceration.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Small myomas are usually completely enucleated, whereas larger ones are partially enucleated. The maximum diameter of the myoma becomes the largest diameter of the morcellated uterus. (a) Planned line of incision; the myoma encircles the uterus; (b) actual striated uterus http://www.apagemit.com/page/video/show.aspx?num=291&kind=2&page=
See this image and copyright information in PMC

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