To evaluate the feasibility, safety, complication and outcomes by the method of operation(Group I, II, III) in 100 women undergoing total vaginal hysterectomy at the Department of Obstetrics and Gynecology, Kyung-Pook National University Hospital
during
the period from March 1993 to July 1994.
@ES The results obtained were as follows.
@EN 1. We performed 100 cases of total vaginal hysterectomy(93.5%) and 7 cases of total abdominal hysterectomy(6.5%).
2. The average age of patients was 45.69±7.80(31~71) years old and 1 nullipara and 7 primiparas and 92 multiparas. The mean parity was 3.
3. The average time of hysterectomy and operation was 34.52±12.80min(11~95 min) and 74.58±24.68min(35~210 min), respectively.
4. The average time of hysterectomy and operation by the method of removing uterus was 26.03±8.39min and 66.86±19.15min in Group I, 36.83±10.28 min and 76.49±29.33min in group II, 42.96±14.96min and 82.58±20.49min in Group III. There was
no
statistically significant in operation time but significant between group I and II, Group I and III in hysterectomy time(p=0.0001).
5. The mean value of preoperative and postoperative Hb was 12.0g/dl and 11.1g/dl. There was statistically significant between preoperative and postoperative hemoglobin(p=0.0001).
6. The mean blood loss was 182.16±191.89ml(20~1,200ml) and 119.94±84.80ml in Group I, 188.80±207.15ml in Group II, 261.54±246.35 ml in Group III. There was only statistically significant between Group I and Group III(P=0.0183).
7. The average weight of uterus was 195.04±138.83gm(34~800gm), and 87.74±35.37gm in Group I, 208.49±114.78gm in Group II, 328.54±147.53gm in group III. There was statistically significant among 3 groups(P=0.0001).
8. The most common endometrial histology was atrophy(39%). There was no statistically significant between endometrial histology and blood loss(p=0.0680).
9. The most common indication was myoma(49%), and CIN(27%), prolapse (10%), adenomyosis(7%), DUB(5%), others(2%).
10. The most common associated procedure was adnexectomy(34%) and AP repair(15%), omentectomy(1%), bladder repair(1%)
11. The minor complication rate was 16% e.g. Hemorrhage required transfusion(5%). Cuff infection(4%), Bladder distension(3%), URI(2%), Bladder laceration(1%), Explo-laparotomy(1%0.
12. The mean hospital days were 4 days(2~29).
13. 46% of operated women had previous abdominal operation.
We concluded that 93.5% of hysterectomy can be done via vagina by coring and morcellation without significant complication and without the need of expensive laparoscopic equipments.
The rate of vaginal route(93.5%) was the highest among the previous other reports.
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