Hysterectomy is currently one of the most common gynaecological surgical procedures. In the United States, hysterectomy is second to Caesarean delivery as the most frequently1
TLH is associated with greater safety, efficacy, and improvement in the patient quality of life compared to total AH in women with benign gynaecological diseases
VH was performed in patients with uterine size equivalent to 8-16 weeks, and was associated with less operation time, less intraoperative blood loss and better postoperative outcomes compared with AH, suggesting that VH is an effective treatment for patients with benign gynaecological diseases
Mistrangelo et al reported that vaginal hysterectomy was safe and effective in cases of greater uterine weight or volume. Guvenal et al found that VH could be performed with less morbidity, even in patients with a large, immobile uterus and previous pelvic surgery. Falcone et al have confirmed the success of the vaginal approach in patients with these characteristics. Rates of urethral and bladder injuries at the time of VH were 0.88% and 1.76%, respectively. Consistent with this, in a recent large case series, the incidence of bowel injury was low in VH patients. conversion rates from the vaginal to abdominal approach have been reported to be of 0.4% in a retrospective review of 220 patients. In this study, no intraoperative complications occurred in patients of the VH group, and no vaginal approach was converted to an abdominal approach
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