M. Cosson et al., THE FEASIBILITY OF VAGINAL HYSTERECTOMY, European journal of obstetrics, gynecology, and reproductive biology, 64(1), 1996, pp. 95-99
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.