Comparative study of abdominal hysterectomy and vaginal hysterectomy in non-descent cases a prospective study


  • Kalpana Mehta Department of Obstetrics and Gynecology, S. N. Medical College, Jodhpur, Rajasthan, India
  • Om Prakash Department of Obstetrics and Gynecology, S. N. Medical College, Jodhpur, Rajasthan, India
  • Dharmendra Singh Fatehpuriya Department of Obstetrics and Gynecology, S. N. Medical College, Jodhpur, Rajasthan, India
  • Leena Verma Department of Pathology, S. N. Medical College, Jodhpur, Rajasthan, India



Abdominal hysterectomy, Non-decent vaginal hysterectomy


Background: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of VH for non-prolapsed indications i.e. non-decent vaginal hysterectomy (NDVH) as the scar less hysterectomy. It has several benefits over abdominal hysterectomy in terms of cosmetic advantages, lesser post-operative morbidity and faster recovery. The objectives of the study was to compare and assess various factors like operative duration of surgery, intra operative blood loss, intra operative and post-operative complications, post-operative analgesia requirement, post-operative ambulation and duration of post-operative hospital stay and to put forward best route of hysterectomy.

Methods: Hundred cases fulfilling, the selection criteria were included in the study. Patients were randomly divided in two groups-NDVH (non-decent vaginal hysterectomy) and abdominal hysterectomy.

Results: Operative time, intra operative blood loss and post-operative morbidity was less in NDVH groups.

Conclusions: Non-decent vaginal hysterectomy is a better alternative to abdominal hysterectomy in cases with benign pathology of the uterus, uterine size <14 weeks, uterus with good mobility and adequate vaginal access.


Lepine LA, Hillis SD, Kieke BA, Marchbanks PA, Koonin LM, Morrow B, Kieke BA, et al. Hysterectomy surveillance—United States, 1980–1993. Morbidity and mortality weekly report: CDC Surveillance Summaries. 1997;46(4):1-15.

Dicker RC, Greenspan JR, Strauss LT, Cowart MR, Scally MJ, Peterson HB, DeStefano F, et al. Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States: the collaborative review of sterilization. Am J Obstet Gynec. 1982;144(7):841-8.

Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB, et al. Hysterectomy in the United States, 1988-1990. Obstetrics & Gynecology. 1994;83(4):549-55.

Kovac SR. Guidelines to determine the route of hysterectomy. Obstetrics & Gynecology. 1995;85(1):18-23.

Harris MB, Olive DL. Changing hysterectomy patterns after introduction of laparoscopically assisted vaginal hysterectomy. Am J obstetrics gynecology. 1994;171(2):340-4.

Querleu D, Cosson M, Parmentier D, Debodinance P. The impact of laparoscopic surgery on vaginal hysterectomy. J American Association Gynecologic Laparoscopists. 1994;1(4, Part 2):S29-S29.

Weber AM, Lee JC. Use of alternative techniques of hysterectomy in Ohio, 1988–1994. New England J Medicine. 1996;335(7):483-9.

Boike GM, Elfstrand EP, DelPriore G, Schumock D, Holley HS, Lurain JR, et al. Laparoscopically assisted vaginal hysterectomy in a university hospital: report of 82 cases and comparison with abdominal and vaginal hysterectomy. Am J obstetrics and gynecology. 1993;168(6):1690-701.

Kovac SR. Vaginal hysterectomy. Bailliere’s Clin Obstet. Gynecol. 1997;11:95-110.

Davies A, Vizza E, Bournas N, O’Connor H, Magos A. How to increase the proportion of hysterectomies performed vaginally. Am J obstetrics gynecology. 1998;179(4):1008-12.

Kovac SR, Christie SJ, Bindbeutel GA. Abdominal versus vaginal hysterectomy: a statistical model for determining physician decision making and patient outcome. Medical Decision Making. 1991;11(1):19-28.

Kovac SR. Guidelines to determine the route of hysterectomy. Obstetrics & Gynecology. 1995;85(1):18-23.

Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC, Lee C. Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger than 6 cm in diameter or uterus weighing at least 450 g: a prospective randomized study. Acta obstetricia et gynecologica Scandinavica. 2002;81(12):1132-8.

Ribeiro SC, Ribeiro RM, Santos NC, Pinotti JA. A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynecology & Obstetrics. 2003;83(1):37-43.

Silva-Filho AL, Werneck RA, de Magalhães RS, Belo AV, Triginelli SA. Abdominal vs vaginal hysterectomy: a comparative study of the postoperative quality of life and satisfaction. Archives gynecology obstetrics. 2006;274(1):21.

Bharatnur S. Comparative study of abdominal hysterectomy versus vaginal hysterectomy in non descent cases. Internet J Gynecology Obstetrics. 2010;15(2).

Miskry T, Magos A. Randomized, prospective, double‐blind comparison of abdominal and vaginal hysterectomy in women without uterovaginal prolapse. Acta obstetricia et gynecologica Scandinavica. 2003;82(4):351-8.

Shanthini NF, Poomalar GK, Jayasree M, Bupathy A. Evaluation of complications of abdominal and vaginal hysterectomy. Int J Reprod Contraception Obstet Gynaecol. 2012;1(1):7-11.

Modi K, Patel S, Gupta S, Barnwal R, Desai A, et al. Non Decent Vaginal Hysterectomy A comparative analysis. IJSR. 2014;3(11):414-6.

Coulam CB, Pratt JH. Vaginal hysterectomy: Is previous pelvic operation a contraindication?. American journal of obstetrics and gynecology. 1973;116(2):252-60.

Chakraborty S, Goswami S, Mukherjee P, Sau M. Hysterectomy…..Which Route?. J Obstetrics Gynecology of India. 2011;61(5):554-7.

Aloknanda R, Luna P, Roshan B, Chaudhary R. Non-Decent Vaginal Hysterectomy: a constantly Improving surgical Art. J Obstetrics and Gynecology India. 2011;61(2):182-8.

Benassi L, Rossi T, Kaihura CT, Ricci L, Bedocchi L, Galanti B, Vadora E. Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J obstetrics gynecology. 2002;187(6):1561-5.

Raju VS, Girija BS. Comparison of vaginal hysterectomy for non-descent uterus with abdominal hysterectomy. Indian J Public Health Research & Development. 2014;5(1):15.

David Soriano MD Daniel S. Seidman Evidence based Obstetrics & Gynecology – Vol 6, Issue 1 (March 2004) – Copyright ©2004 Churchill.

Mahasani V, Suchdeva R, Aggarwal A. Hysterectomy-which approach. People’s J Scientific Research. 2014;7(1):17-21.






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