Our experience on non-descent vaginal hysterectomy: a forgotten skill

Background: Hysterectomy is the most commonly performed major gynecological procedure. It can be done by different routes like abdominal or vaginal or laparoscopic route. Vaginal route of hysterectomy is undoubtedly less popular these days due to inclination towards laparoscopic route by both surgeon as well as patients. Keeping this is mind we have planned this paper to share our experience of Non Descent Vaginal Hysterectomy at a tertiary level hospital.Methods: A retrospective study was conducted at the department of obstetrics and gynecology of Vardhmann Mahavir Medical College & Safdarjung hospital, New Delhi over the period of one year. All the patients undergoing non -descent vaginal hysterectomy for benign indication with adequate vaginal access, without suspected adnexal pathology, who did not have any uterine descent were included in the study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing was used to remove the uterus. Intraoperative findings and post-operative complications were recorded. Statistical analysis was done.Results: During the study period total 138 hysterectomies were performed. Most of the women were in the age group of 46 to 50 years (50%). All patients were parous. In 56% patients, uterine size was 8-10 weeks. Fibroid uterus (37%) followed by adenomyosis (27%) was the commonest indication for hysterectomy. The most common complication was febrile morbidity (n=13) followed by urinary tract infection (n=9).Conclusions: Non descent vaginal hysterectomy procedure in hand of a skilled surgeon can be done upto 14 weeks uterine size.