Comparative study of morbidity and mortality associated with nondescent vaginal hysterectomy and abdominal hysterectomy based on ultrasonographic determination of uterine volume

This is a prospective and comparative study of 150 patients each operated on for vaginal and abdominal hysterectomy for indications other than utero-vaginal prolapse between January 2004 and December 2005. Age, parity, and anesthesia were matched in both groups. A preoperative examination under anesthesia and sonographic estimation of uterine volume were done to decide the feasibility of vaginal hysterectomy. Various debulking techniques such as hemisection, enucleation, and wedge resection were used for the vaginal route. Leiomyomas were the most common indication in both groups. The mean time taken was less in the vaginal group (39.07 versus 45.56 minutes). The average blood loss (35.36 versus 108.5 g) and the mean hospital stay (3.71 versus 7.84 days) were also significantly less in the vaginal group than in the abdominal group. The overall postoperative morbidity and period of convalescence were also reduced in the vaginal group.