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Vaginal hysterectomy in nulliparous women without prolapse: a prospective comparative study
Author(s) -
Agostini Aubert,
Bretelle Florence,
Cravello Ludovic,
Maisonneuve Anne Sophie,
Roger Valérie,
Blanc Bernard
Publication year - 2003
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1046/j.1471-0528.2003.01447.x
Subject(s) - medicine , hysterectomy , laparotomy , obstetrics , gynecology , prospective cohort study , complication , laparoscopy , oophorectomy , population , surgery , environmental health
Objective To compare vaginal hysterectomy success and complication rates in nulliparous and primiparous or multiparous women. Design A comparative prospective study. Setting Department of Gynaecology, La Conception Hospital, Marseille, France. Population Three hundred and forty‐five consecutive patients without genital prolapse requiring hysterectomy for benign conditions and without previous pelvic surgery or caesareans were treated prospectively by vaginal hysterectomy. Fifty‐two patients were nulliparous and 293 were primiparous or multiparous. Methods Data of patients were collected prospectively. Main outcome measures Operative time, length of hospital stay, oophorectomy, conversion to laparotomy, intra‐ and post‐operative complications. Results The mean operative time was significantly longer in nulliparous patients [95 (55.2) vs 79.9 (34.9) minutes, P < 0.01 ]. The overall complication rate was significantly higher [7/52 (13.46%) vs 13/293 (4.44%), P = 0.02, RR = 3.03 (1.27–7.23) ] as was the haemorrhage rate in nulliparous compared with the primiparous and multiparous women [4/52 (7.69%) vs 5/293 (1.7%), P = 0.03, RR = 4.51 (1.25–16.23) ]. Vaginal hysterectomy was successfully performed in 96.2% (50/52) of the nulliparous and 99.7% (292/293) of the parous patients [ P = 0.06, RR = 1.04 (0.98–1.09) ]. Conclusion The success rate of vaginal hysterectomy in nulliparous women is high. However, the risk of complications seems higher than in the parous women. Laparoscopy assisted vaginal hysterectomy in nulliparous women needs further investigations.