Laparoscopic vs vaginal hysterectomy for benign pathology

Am J Obstet Gynecol. 2009 Apr;200(4):368.e1-7. doi: 10.1016/j.ajog.2008.09.016. Epub 2009 Jan 10.

Abstract

Objective: The objective of the study was to compare length of stay, blood loss, operative time, and pain of laparoscopic and vaginal hysterectomy.

Study design: This was a prospective, randomized, controlled comparison between vaginal (VH) and laparoscopic (LH) hysterectomy among 60 consecutive patients with a uterine volume of 300 mL or less and without uterine prolapse. Patients were followed up for 12 months.

Results: The groups were significantly different for mean operative time (VH: 81 +/- 30 minutes; LH: 99 +/- 25 minutes; P = .033) and blood loss (LH: 83 +/- 57 mL; VH: 178 +/- 149 mL; P = .004). Bilateral adnexectomy was performed when preoperatively planned in 73% of cases of the vaginal arm, whereas it was always performed in the laparoscopic arm (P = .045). Postoperative pain on day 0 and the number of days of analgesic request were higher in the vaginal group (P = .023 and P = .017, respectively). LH was associated with a reduced hospital stay (LH: 2.7 +/- 0.5 days; VH: 3.2 +/- 0.6 days; P < .001).There were no differences between the groups at the follow-up.

Conclusion: Laparoscopic hysterectomy results in a shorter hospital stay, less blood loss, and less postoperative pain compared with vaginal hysterectomy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Female
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy*
  • Middle Aged
  • Prospective Studies
  • Uterine Diseases / surgery*
  • Vagina