Non-descent vaginal hysterectomies: a brief report

Hysterectomy is the most common gynecological procedure carried out worldwide. The objective of this study is to provide evidence for the safety, efficacy, and cost-effectiveness of hysterectomy through the vagina for a non-descent uterus. Natural Orifices Transluminal Endoscopic Surgery is an alternative for non-descent uteruses. However, performing Non-Descent Vaginal Hysterectomy (NDVH) in Sri Lanka is not popular due to various reasons.This case series includes seven patients who have undergone NDVH for benign gynecological conditions. The median age was 47. The median hemoglobin difference was 0.7 g/dl (IQR = 0.4), and the median time for the surgery was 40 minutes (IQR = 10). All of them were discharged within 24 hours except one which was retained to optimize her medical condition. The largest uterus which was removed in this study weighed 312 grams and the longest time spent was recorded as 72 minutes in the same case. The use of new technology like Ligature and Bi Clamp vessel sealer helped to reduce the operation time. Factors in favor of NDVH include large pelvis mobile, smaller uterus (less than 14 weeks), previous vaginal births, and multiparity, experience, and training of the surgeon.The study concludes that non-descent vaginal hysterectomy is a safe and effective surgical treatment for benign gynecological diseases.