A Prospective Study to Compare the Outcome of Nondescent Vaginal Hysterectomy and Total Laparoscopic Hysterectomy for Benign Gynecological Conditions

Background: Minimal invasive hysterectomy techniques include nondescent vaginal hysterectomy (NDVH) and total laparoscopic hysterectomy (TLH). Study objective was to compare the intraoperative findings and outcomes of NDVH and TLH among women with benign gynecological disorders of the uterus. Methods: A prospective study was done on 124 women with benign gynecological conditions. The study subjects were alternatively divided into two procedure groups: NDVH ( n =62) and TLH ( n =62). Both techniques (NDVH and TLH) were compared in terms of operative time, blood loss, and outcome measures such as difficulties during operation, complications, postoperative pain, postoperative ambulation, and duration of hospital stay. p less than 0.05 was taken as a cut-off point for statistical significance. Results: In the NDVH group, the mean age was 46.13 years, while in the TLH group, the mean age was 45.42 years ( P =0.503). Compared to TLH group, NDVH group had significantly lesser mean operative time (51.26±8.19 vs. 105.48±12.37 minutes); lesser mean doses of analgesia (4.55±0.76 vs. 6.13±0.74); shorter ambulation time (15.81±1.45 vs. 24.95±3.38 hours); significantly shorter discharge times (2.24±0.64 vs. 3.10±1.22 days); and shorter time taken to resume normal day-to-day activities (7.39±0.71 vs. 16.27±3.59 days); significantly lower mean VAS scores on postoperative day 1 (4.87±0.86 vs. 5.94±0.67), day 2 (1.97±0.9 vs. 3.76±0.69), and day 3 (1.66±0.85 vs. 2.92±0.55), ( P <0.0001 for all). Blood loss, surgical difficulties, postoperative blood transfusion, drop in hemoglobin level, and postoperative complications were statistically comparable. Conclusion: NDVH proved to be a faster operative technique, with lesser pain scores, lesser analgesia, shorter ambulation time, and statistically comparable proportion of complications, compared to TLH.