THE FEASIBILITY OF VAGINAL HYSTERECTOMY

Objective: To assess the feasibility of vaginal hysterectomy for benig n uterine disease and to assess how frequently laparoscopic assistance is necessary. Methods: A prospective series of 806 hysterectomies for benign disease of the uterus without prolapse which were performed in our institution from 1 March 1991 to 28 February 1994 is discussed. T he report is an evaluation of a planned approach for hysterectomy. Vag inal hysterectomy was performed whenever possible - laparoscopic hyste rectomy was indicated for adnexal pathology, known or anticipated sign ificant pelvic adhesions and for a narrow vaginal access with a modera tely enlarged uterus - abdominal hysterectomy was chosen when both lap aroscopic and vaginal surgery were judged to be impossible. Results: V aginal hysterectomy was performed in 80.6% of patients. Laparoscopic a ssistance was needed in 9.4% of cases. The need for laparotomy was red uced to 10% with an acceptable pre- or postoperative complications rat e.