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At least 19 recordsLinked to original sources
PubMed2026

Vaginal Hysterectomy Versus Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery Hysterectomy; Results of a Randomised Controlled Trial.

OBJECTIVE: To compare Vaginal Hysterectomy (VH) with Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery (NOTES) hysterectomy (VANH) as a day-care procedure. DESIGN: Single-blind, multicentre randomised controlled trial. SETTING: Two Dutch non-academic teaching hospitals. POPULATION: Women aged &#x2265;&#x2009;18&#x2009;years undergoing hysterectomy for benign indications. METHODS: Women were randomised 1:2 (VH or VANH). Primary outcome was SDD. Secondary outcomes included operative time, rate of elective salpingectomies, intraoperative blood loss, complications (Clavien-Dindo), pain scores (NRS) and analgesic use, post-operative recovery (RI-10), and quality of life (EQ-5D-5L). Analyses were performed on an intention-to-treat basis. RESULTS: A total of 113 patients were included in the analyses (n&#x2009;=&#x2009;42 VH, and n&#x2009;=&#x2009;71 VANH). SDD occurred significantly more frequently in the VANH group (87.3%) than VH group (71.4%; OR 2.76, 95% CI 1.04-7.25; p&#x2009;=&#x2009;0.04). VANH was associated with a significantly shorter operative time (median 55&#x2009;min versus 65&#x2009;min; p&#x2009;=&#x2009;0.005), less blood loss (median 50&#x2009;mL vs. 150&#x2009;mL; p&#x2009;<&#x2009;0.001) and more often elective opportunistic salpingectomy compared to VH (100% vs. 77.4%; p&#x2009;=&#x2009;0.008). NRS were significantly lower in the VANH group the first hour post-operative (3 vs. 1, p&#x2009;<&#x2009;0.001). Post-operative complications (VH 9.5% vs. VANH 15.5%; p&#x2009;=&#x2009;0.34), readmission (VH 4.8% vs. VANH 8.5%; p&#x2009;=&#x2009;0.47), analgesic use, recovery, and quality of life were not statistically significant. CONCLUSIONS: VANH is a safe and effective alternative to VH, offering a higher likelihood of SDD, shorter operative time, reduced blood loss, and more often an elective salpingectomy, without increased complications or differences in pain, recovery, or quality of life.

Humans↗
PubMed1976

The effect of prophylactic ampicillin on pelvic infection following vaginal hysterectomy.

One hundred patients undergoing vaginal hysterectomy at the University of Kentucky Medical Center were given prophylactic ampicillin and compared to one hundred control patients. The use of prophylactic ampicillin caused significant reduction in both postoperative pelvic infection and hospital stay. However, two patients in the prophylactic antibiotic group later required readmission for infections resistant to ampicillin. Prophylactic antibiotics are beneficial in vaginal hysterectomy, but careful follow-up of all patients is mandatory.

Abscess↗
PubMedDate not supplied

[Complications following vaginal hysterectomy].

The author analyses complications following 817 vaginal hysterectomies (VH). The mortality rate was 0.24%. Laparotomy during VH was performed in 3 patients (0.36%): twice the commenced VH was completed abdominally (once owing to the overlooked fixed uterus in a very obese patient and once owing to the previously performed Doleris operation). These are so-called unsuccessful vaginal hysterectomies. In the third patient laparotomy was applied owing to the bleeding from the retracted, cut uterine artery. Injuries of the urinary pelvis during the VH procedure occured in two patients: once during the opening of the plica vesico-urinaris and once during the opening of the Douglas sac (in the patient with a previous Doleris operation). Both injuries were cured vaginally. Early complication were recorded in 34.02% (278 cases). Most infections occurred in the small pelvis. Late complications were encountered in 41.07% (207 cases) out of 504 followed-up patients. Granulation tissue has proved to be the most frequent complication in this group of women (33.13%). Incontinentia urinae was found in 2.5% (13 cases).

Acute Kidney Injury↗
PubMed1978

Salpingo-oophorectomy at the time of vaginal hysterectomy.

Three hundred fifty-five cases of vaginal hysterectomy associated with bilateral or unilateral salpingo-oophorectomy were reviewed to assess the safety and feasibility of adnexa removal when such was necessary or desirable. Other than one instance of hemorrhage from ovarian vessels, no serious complications, including ureteral injuries, could be assigned specifically to the removal of the adnexa. Our opinion is that the techniques for salpingo-oophorectomy at the time of vaginal hysterectomy should be taught to residents and practiced by gynecologic surgeons.

Adult↗
PubMed1979

Ectopic pregnancy following total vaginal hysterectomy.

A case of ectopic pregnancy following vaginal hysterectomy is reported. A review of the literature reveals 22 similar cases, with 12 presenting as early postoperative complications and 10 as late postoperative complications. The pathophysiology is discussed. Although it is a remote possibility, there must be an awareness that ectopic pregnancy can occur in women with acute abdominal pain following hysterectomy.

Adult↗
PubMed1977

Vaginal hysterectomy in obese women.

The influenced of obesity in vaginal hysterectomy was examined by comparing the characteristics and outcome in 108 patients who weighed 200 pounds or more with matched controls weighing less than 200 pounds. Obese and nonobese subjects were similar in age and surgical indications, though overweight patients, who averaged nearly 60% above standard weight for height and age, were more likely to have hypertension and diabetes mellitus. Both operating time and operative blood loss were greater in obese patients, presumably because of more frequent employment of vaginal repair in this group. However, obese and nonobese patients did not differ significantly with respect to mortality (none in either group), postoperative febrile morbidity (62 and 56%, respectively), or postoperative hospitalization in excess of 12 days (19 and 16%, respectively). Thus, obesity does not seem to impose additional risks in vaginal hysterectomy, in contrast to abdominal hysterectomy in which the increased morbidity relates to wound infection.

Female↗
PubMed1978

Single dose preoperative prophylactic antibiotic in vaginal hysterectomy.

A retrospective study of patients following vaginal hysterectomy showed a postoperative morbidity of 75%. A trial of a single preoperative intravenous injection of cephalothin sodium to patients about to undergo vaginal hysterectomy showed a significant (P less than 0.01) reduction in postoperative morbidity.

Anti-Bacterial Agents↗
PubMed1979

Simplified antibiotic prophylaxis for vaginal hysterectomy.

Single dose administration of antibiotics prior to vaginal hysterectomy was found to be an efficient and safe way of providing prophylaxis against infection. Metronidazole was as efficient as ampicillin in achieving a significant reduction in major morbidity, pelvic sepsis, and the "quantity" of postoperative fever. Antibiotic prophylaxis reduced hospital stay by an average of 3 days.

Adult↗
PubMed1976

Vaginal hysterectomy by an anterior colpotomy technic.

A simple, relatively unknown technic of vaginal hysterectomy using the anterior colpotomy approach is presented. Experience with this procedure at a small Naval hospital is described. Morbidity occurred in 6.6% of the patients. The advantages of this method of vaginal hysterectomy are summarized.

Adult↗
PubMed1979

Preoperative hot conization of the cervix: a possible method to reduce postoperative febrile morbidity following vaginal hysterectomy.

Laboratory results indicate that the endocervix may be a source of bacterial contamination when vaginal hysterectomy is performed. In a series of 160 consecutive vaginal hysterectomies in premenopausal women, hot conization of the cervix was performed prior to the scrub with an iodophore. No preoperative antibiotics were used in this series. The postoperative febrile morbidity rate was 4.3 per cent and the average stay was 4.5 days. These results are compared with those of three other groups: (1) patients who received a three-dose parenteral prophylactic antibiotic course with the first dose two hours prior to surgery had a febrile morbidity rate of 8.6 per cent. (2) In patients who had prophylactic antibiotics for five days with the first dose given intraoperatively, the febrile morbidity rate was 10.1 per cent. (3) The febrile morbidity rate in the group with no antibiotic prophylaxis or hot conization was 49.1 per cent. Laboratory and clinical data suggest that preoperative conization may be effective in the reduction of postoperative febrile morbidity.

Anti-Bacterial Agents↗
PubMed1977

Vaginal hysterectomy.

The role of antibiotic prophylaxis in women undergoing vaginal hysterectomy is reviewed. Although there has been a wide range in the reported incidence of postoperative infection and a wide variation in the definition of infectious morbidity, all of the reported studies to date have shown a decrease in the number of infections with this regimen. Currently, a short perioperative course with the cephalosporins is recommended for patients not allergic to penicillin, and this continues to be effective. A short alternative regimen for the penicillin-allergic patient has not been studied as yet.

Abscess↗
PubMed1975

The prophylactic use of Keflex and Keflin in vaginal hysterectomy.

Although the number of severe infections occurring after vaginal hysterectomy are few,they sometimes result in the death of a patient or a protracted hospital course. A prospective double-blind study, using Keflex and Keflin in theraputic doses,was undertaken to elucidate more clearly the effect upon morbidity in vaginal hysterectomy. Cultures were taken form a catheterized urine specimen and the cervix of all patients before surgery. Cultures were repeated on the fourth postoperative day. Morbidity was defined as an oral temperature of 100.6 degrees F. on two separate occasions, 4hours apart in the postoperative period. Of the 60 patients studied thus far, 43.3 percent of the 30 placebo patients exceeded these febrile limits and were determined as thosewith infectious morbidity. Only 13.3 of the 30 patients who received the prophalatic drug showed this morbidity.

Adult↗
PubMed1977

Prophylactic antibiotics for women undergoing vaginal hysterectomy.

A triple-blind prospective study of women undergoing vaginal hysterectomy was conducted to compare cefazolin, cephaloridine and no antibiotic, Both cefazolin and cephaloridine were given preoperatively, whereas only cephaloridine was given postoperatively. One gram of cefazolin given intramuscularly on call to the operation room was found to be a safe and effective antibiotic for prophylaxis against febrile morbidity. The proper utilization of prophylactic antibiotics seems to be in the immediate preoperative period. The use of antibiotics after the first day of surgery is unnecessary.

Adult↗
PubMed1976

Vaginal hysterectomy be anterior delivery of the uterine corpus.

Of 285 vaginal hysterectomies done by a modification of the Doderlein-Kronig technic, almost 70% of patients had an intraoperative blood loss of less than 200 ml. Only four required transfusions. A postoperative pelvic abscess was the only severe infection, and it responded to treatment. One patient had a ruptured ectopic pregnancy 46 days after hysterectomy. Advantages of this procedure are good anatomic exposure and minimal blood loss.

Adult↗
PubMed1979

Effect of single and multidose cephradine prophylaxis on infectious morbidity of vaginal hysterectomy.

The administration of cephradine prophylactically to patients who were undergoing vaginal hysterectomies resulted in a marked and significant reduction in the incidence of postoperative infections when compared to a placebo group. Cephradine was the cephalosporin studied because of its unique pharmacodynamic properties, which result in high uterine tissue levels. The protective effect was similar whether 1 g was given preoperatively followed by 500 mg IV q. 6 hours for 4 doses, or a single dose of 2 g IV given approximately 1 hour before surgery. Uterine tissue and serum levels of antibiotic were high and correlated with the degree of protection noted.

Adult↗