331763

Comparative Analysis of Non-Descent Vaginal Hysterectomy in Nulliparous and Parous Women: Insights from a Retrospective Study

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Last updated: 03 Jan 2025

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Abstract

Background: A lot of alleged contraindications to Non-Descent Vaginal Hysterectomy (NDVH) were cited by lay gynecologic surgeons: is this true? Objective: This study aimed to compare NDVH achievement rate and perioperative consequences in nulliparous and parous women. Methods: This retrospective cohort study involved 1008 patients who had NDVH between 2010 and 2023 at Benha University Hospital and private centers. Results:  203 (20.1%) were nulliparous (reference group), while 805 (79.9%) were parous, out of parous women 202 (20%) were primiparous, while 603 (59.9%) were multiparous (investigational group). Both groups were parallel regarding most preoperative features and no clinically significant alterations were perceived in perioperative consequences as transfusion, ureteral and bladder or bowel injuries, fever, systemic infections, fistula, conversion to total abdominal hysterectomy and total postoperative complications (P>0.05). NDVH was successfully executed in 97.04% (197/203) of the nulliparous and 98.01% (789/805) of the parous women [P = 0.39, relative risk (RR) = 1.48, 95% CI (0.58–3.79), number need treat (NNT), i.e. gynecologist need to operate upon 103 women  to meet one case converted to abdominal hysterectomy]. No difference was noticed in overall intraoperative complications rate [16/203 (7.9%) vs 61/805(7.3%), P = 0.37, RR = 1.03 (0.61–1.76)], but the EBL was less in nulliparous compared to parous women (295  ± 140 vs.405  ± 160, D (95% CI) =110 (85.9 to 134.1), P=0.0001). Conclusions: The results regarding intraoperative switching to TAH, achievement rate of NDVH and perioperative consequences revealed that NDVH is secure and viable in nulliparous women and gynecologic surgeon shouldn't deem nulliparity as a contraindication for NDVH and the maluses of laparoscopy for hysterectomy should be revised.

DOI

10.21608/ejhm.2023.331763

Volume

93

Article Issue

1

Related Issue

43798

Issue Date

2023-10-01

Receive Date

2023-12-23

Publish Date

2023-10-01

Page Start

7,840

Page End

7,847

Print ISSN

1687-2002

Online ISSN

2090-7125

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https://ejhm.journals.ekb.eg/article_331763.html

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https://ejhm.journals.ekb.eg/service?article_code=331763

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141

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Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Comparative Analysis of Non-Descent Vaginal Hysterectomy in Nulliparous and Parous Women: Insights from a Retrospective Study

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Article

Created At

24 Dec 2024