LAVH superior to TVH when concomitant salpingo-oophorectomy is intended in prolapse hysterectomy: a comparative cohort study

Purpose

This comparative cohort study evaluated the influence of surgical route for prolapse hysterectomy (vaginal or laparoscopically assisted) on the achievement of intended elective salpingo-oophorectomy, which was a procedural goal planned with the patient before primary vaginal native-tissue prolapse surgery.

Methods

Consecutive patients who underwent total vaginal hysterectomy (TVH; n?=?163) or laparoscopically assisted vaginal hysterectomy (LAVH; n?=?144) and vaginal native-tissue repair for pelvic organ prolapse at Jena University Hospital were enrolled.

Results

Peri- and postoperative parameters, including Clavien–Dindo (CD) classification of surgical complications, were compared between groups using Student’s t test, Fisher’s exact test, and multivariable regression. Patient characteristics were similar, except that grade IV prolapse was more common in the LAVH group (p? p < 0.001), operating time (153?±?61 vs. 142?±?27 min), and postoperative in-patient days (9.02?±?4.9 vs. 4.99?±?0.96; all p?

Conclusions

LAVH enabled the safe performance of planned concomitant salpingo-oophorectomy in all cases. To achieve the procedural goal in such cases, laparoscopic assistance in prolapse hysterectomy should be considered.