Renaissance for Vaginal Hysterectomy

Abstract

To answer the question how to increase the proportion of VH in ASMH, a prospective observational case-series study was held at the department of Obstetrics and Gynecology in Ain-Shams University Hospitals (ASMH) for 300 consecutive hysterectomies performed for various indications other than emergency indications. The purpose of the study was to identify the characteristics of women undergoing hysterectomy for various indications and to estimate the proportion of hysterectomies that could have been done vaginally by recognized surgical techniques.

In an ideal situation, it is the interplay of risks and benefits to the patient that should influence the process of decision-making. The factors related to the physician and institution should be reduced to minimum (Kovac, 1991).

In ASMH, the current total number of elective hysterectomy procedures has increased from 6 procedures per week in the mid-nineties (Mehesen thesis, 1997) to 9-10 procedures per week in the year 2000- 2001. The current VH proportion in ASMH is also higher than that of the mid-nineties (30.3% versus 13.2%). Inspite of that, this proportion represents less than half the proportion of patients potentially suitable for VH (i.e. 63.3%) estimated in this study by examining the patients clinical criteria.