Evaluation of outcome following paracervical infiltration with or without saline and adrenaline during vaginal hysterectomy


  • Jayaraman Nambiar M. Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal, India
  • Bhaygarekha Yettinamani Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal, India
  • Muralidhar V. Pai Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal, India




Laparoscopic assisted vaginal hysterectomy, Saline Adrenaline infiltration, Vaginal hysterectomy


Background: Paracervical infiltration is used in vaginal hysterectomy to facilitate dissection. Use of paracervical infiltration however can be associated with local ischemia and infection. We did a study to find out its benefits during vaginal hysterectomy.

Methods: It was a prospective case control study. Patients were divided into two groups. In the first group, no paracervical infiltration was given. In the second group paracervical infiltration was given before hysterectomy. The operating time, blood loss and postoperative infection were noted in each group.

Results: The operating time was slightly higher in vaginal hysterectomy group without infiltration (p=0.025) The operating time in laparoscopic assisted vaginal hysterectomy group was not significant (p=0.0296). There was significant difference in Hemoglobin after surgery in both groups (p value 0.614 for vaginal hysterectomy and 0.173 for laparoscopic assisted vaginal hysterectomy). There was no case of infection in both groups.

Conclusions: From our study, we concluded that paracervical infiltration offers no distinctive advantage during vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy. 


Nosan M, Novak F, Mazovec M The decrease of hemorrhages in vaginal hysterectomies through administration of adrenaline, octapressine, Gynaecology. 1968;165(1):21-30.

England GT, Randall HW, Graves WL Impairment of tissue defences by vasoconstrictors in vaginal hysterectomies. Obstet Gynecol. 1983;61(3):271-4.

Julian TM, Johnson GW, Gosewhr JA. Vasopressin as a chemical tourniquet during vaginal surgery. J Gynecol Surg. 1993;9:161-4.

Latthe P, Kadian S, Parsons M, Toozs-Hobson P. Survey of use of local infiltration and vasoconstrictor in vaginal surgery. Gynecol Surg. 2007;4:187-9.

Ghezzi F, Cromi A, Raio L, Bergamini V, Triacca P, Serati M et al. Influence of the type of anesthesia and hydrodissection on the complication rate after tension-free vaginal tape procedure. Eur J Obstet Gynecol Reprod Biol. 2005;118(1):96-100.

Caliskan K, Nursal TZ, Yildirim S, Moray G, Torer N, Noyan T. Hydrodissection with adrenaline-lidocaine-saline solution in laparoscopic cholecystectomy. Langenbecks Arch Surg. 2006;391(4):359-63.






Original Research Articles