Purohit technique of vaginal hysterectomy in nulliparous women: is it a matter waste of time?

ABSTRACT

To ease intraoperative access to parauterine space at vaginal hysterectomy, we choose the purohit technique of vaginal hysterectomy using a right angle forceps, electrocautery and 10 mm telescope with light source, to evaluate the role of parity. The study comprised a total of 30 women without prolapse who requested hysterectomy for different benign diseases of the uterus between April 2001 and March 2003. They were grouped to two distinct groups according to parity; group 1 [G1] 14 nuillparous and group 2 [G2] 16 parous women. Exclusion criteria included uterine size above 16 weeks, known pelvic endometriosis and early stages of organ confined malignancy. We compared vaginal hysterectomy success, failure and safety according to parity. Safety was measured from intra and postoperative complications, duration of operation and hospital stay. The overall complication rate showed no significant difference between the two groups as regard to intraoperative and postoperative complications. The mean operative time was significantly longer in nulliparous group [99 SD +/- 55.6 vs 72 SD +/- 32.8 minutes, p<0.05]. However the mean hospital stay showed no significant difference between the two groups [in nulliparous group 6.42 +/- 4.52 and 6.22 +/- 3.92 in parous groups]. The success rate was 85.7% [12/14] in nulliparous group and 87.5% [14/16] in parous group. So, it could be concluded that, using this technique nulliparity was not an obstacle to the vaginal route and, purohit technique of vaginal hysterectomy is not a waste of time in nulliparous women