Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
The Journal of Obstetrics and Gynecology of India
Published in: The Journal of Obstetrics and Gynecology of India 1/2016

01-10-2016 | Original Article

Non-decent Vaginal Hysterectomy in Rural Setup of MP: A Poor Acceptance

Authors: Sapna B. Jain, Kshma D. Chandrakar

Published in: The Journal of Obstetrics and Gynecology of India | Special Issue 1/2016

Login to get access

Abstract

Objective

NDVH is a minimally invasive, safe, effective, and economical surgery. Still AH is preferred for benign gynaecological indications. Our study aims to promote NDVH in all technically possible cases by adequate counselling of the patient.

Methods

This prospective observational study enrolled 100 women seeking hysterectomy for benign gynaecological conditions (excluding prolapse) in a teaching hospital. Women were counselled on the basis of ‘PREPARED’ questionnaire to assess their awareness about NDVH and were offered NDVH as the proposed surgery and result is analysed.

Results

We observed that there was a little awareness about NDVH and its outcome among the subjects. Ten out of 100 patients refused to perform NDVH after counselling and underwent TAH. Rest of the 90 patients opted for NDVH. Forty out of 90 patients were aware about NDVH, but they were sceptical about the outcome, and 50 were totally unaware. After applying ‘PREPARED’ questionnaire and counselling, we could motivate them to accept NDVH. It was successful in all cases except one where laparotomy was done for ovarian artery retraction. With no significant post-operative complications, early return to routine activity and low cost of surgery, all patients were satisfied with surgical outcome and improved quality of life.

Conclusion

We conclude that patients accept the surgery with open mind after proper counselling and detailing of the procedure. Most of the abdominal hysterectomy can be converted successfully to NDVH in technically feasible cases by experienced hands so adequate training to gynaecology residents is the need of the time. NDVH is economical to the patient as well as for the healthcare system.
Literature
1.
Kovac SR, Barhan S, Lister M, et al. Guidelines for the selection of the route of hysterectomy: application in a resident clinic population. Am J Obstet Gynecol. 2002;187:1521–7.CrossRefPubMed
2.
Kovac SR. Hysterectomy outcomes in patients with similar indications. Obstet Gynecol. 2000;95:787–93.PubMed
3.
Maresh MJ, Metcalf MA, McPherson K, et al. The VALUE national hysterectomy study: description of the patient and their surgery. Br J Obstet Gynaecol. 2002;109:302–12.CrossRef
4.
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2009;114(5):1156–8.CrossRef
5.
Sheth SS. Vaginal or abdominal hysterectomy? In: Sheth SS, editor. Vaginal hysterectomy. 2nd ed. Jaypee Brothers Medical Publishers (P) Ltd: New Delhi, India; 2014. p. 273–93.
6.
Moen MD, Richter HE. Vaginal hysterectomy: past, present, and future. Int Urogynecol J. 2014;25(9):1161–5.CrossRefPubMed
7.
8.
Barton-Smith P. Clinical practice: Modernizing hysterectomy surgery—is robotics the answer? RCOG Membersh Matters. 2011;1(1):14–5.
9.
Dicker RC, Greenspan JR, Strauss LT, 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 Gynecol. 1982;144:841–8.CrossRefPubMed
10.
Ray A, Pant L, Magon N. Deciding the route for hysterectomy: Indian triage system. JOGI. 2015;65(1):39–44.
11.
Ransom SB, McNeeley SG, Malone JM Jr. A cost-effectiveness evaluation of preoperative type-and-screen testing for vaginal hysterectomy. Am J Obstet Gynecol. 1996;175(5):1201–3.CrossRefPubMed
12.
Sharma C, Sharma M, Raina R, et al. Gynecological diseases in rural India: a critical appraisal of indications and route of surgery along with histopathology correlation of 922 women undergoing major gynecological surgery. J Midlife Health. 2014;5(2):55–61.PubMedPubMedCentral
13.
Singh A (2007) Profile of hysterectomy cases in rural North India. Internet J Gynecol Obstet 7(1).
14.
Callen M, Lettenmaier C, Green CP. Counselling makes a difference. In: Population Reports, Series J. Baltimore, Johns Hopkins School of public health, Publication Information Programme 2001 No. 1.
15.
Dayaratna S, Goldberg J, Harrington C, et al. Hospital costs of total vaginal hysterectomy compared with other minimally invasive hysterectomy. Am J Obstet Gynecol. 2014;210:120.e1–6.CrossRef
16.
Dorsey JH, Holtz PM, Griffiths RI. Cost and changes associated with three alternative techniques of hysterectomy. N Engl J Med. 1996;335:476–82.CrossRefPubMed
17.
Rogo-Gupta LJ, Lewin SN, Kim JH, et al. The effect of surgeon volume on outcomes and resource use for vaginal hysterectomy. Obstet Gynecol. 2010;116:1341–7.CrossRefPubMed
18.
Tohic AL, Dhainaut C, Yazbeck C, et al. Hysterectomy for benign uterine pathology among women without previous vaginal delivery. Obstet Gynecol. 2008;111(4):829–37.CrossRefPubMed
19.
Agostine A, Bretelle F, Cravello L, et al. Vaginal hysterectomy in nulliparous women without prolapse: a prospective comparative study. Int J Obstet Gynecol. 2003;110:515–8.
20.
Sheth SS, Malpani AN. Vaginal hysterectomy following previous caesarean section. Int J Gynecol Obstet. 1995;50:165–9.CrossRef
21.
Khung TTG. An approach to Vesico uterine peritoneum through a new surgical space for vaginal hysterectomy in a patient with history of caesarean section. Malays J Obstet Gynaecol. 1995;4:39–42.
22.
23.
Garg PK, Deka D, Malhotra N. Non descent vaginal hysterectomy for benign condition. A better proposition than abdominal hysterectomy. Obs and Gynae Today. 2002;6:345–6.
24.
Penketh R, Griffiths A, Chawath S. A prospective observational study of the safety and acceptability of vaginal hysterectomy performed in a 24-hour day case surgery setting. BJOG. 2007;114(4):430–6.CrossRefPubMed
25.
Silva Filho AL, Andrade R, de Magalhaes RS, et al. Abdominal vs vaginal hysterectomy: a comparative study of the postoperative quality of life and satisfaction. Arch Gynecol Obstet. 2006;274(1):21–4.CrossRefPubMed
26.
Nieboer TE, Johnson N, Lethaby A, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2009;8(3):CD003677.
27.
Zakaria MA, Levy BS. Outpatient vaginal hysterectomy: optimizing perioperative management for same-day discharge. Obstet Gynecol. 2012;120:1355–61.CrossRefPubMed
28.
Ocheke AN, Ekwempu CC, Musa J. Underutilization of vaginal hysterectomy and its impact on residency training. West Afr J Med. 2009;28(5):323–6.PubMed
Metadata
Title
Non-decent Vaginal Hysterectomy in Rural Setup of MP: A Poor Acceptance
Authors
Sapna B. Jain
Kshma D. Chandrakar
Publication date
01-10-2016
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue Special Issue 1/2016
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-016-0858-2

Other articles of this Special Issue 1/2016

The Journal of Obstetrics and Gynecology of India 1/2016 Go to the issue

Original Article

Homocysteine as Predictive Marker for Pregnancy-Induced Hypertension—A Comparative Study of Homocysteine Levels in Normal Versus Patients of PIH and Its Complications

Original Article

In Laparoscopic Myomectomy, Does a Caseload of 100 Patients During the Learning Curve Produce a Significant Improvement in Performance Measures?

Original Article

Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer

Original Article

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Original Article

Admission Cardiotocography: A Predictor of Neonatal Outcome

Original Article

The Role of Completion Surgery in Ovarian Cancer