Total Laparoscopic versus Vaginal Hysterectomy: The experience of a Training Hospital.

Objective: To compare the operative outcomes of total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) in a training and research hospital. Material and Methods: Retrospective data analysis of all women who underwent either TLH or VH at gynecology unit for benign pathologies between January, 2012 and June, 2015 were conducted. Hysterectomies for desensus uteri were excluded. Groups were compared regarding operation time, change in hemoglobin value, intraoperative complications, postoperative complications and length of hospital stay. Results: During the study period, 120 patients underwent TLH and 192 patients underwent VH. Indications for surgery except desensus uteri were myomas (n= 55), endometrial hyperplasia (n= 43), dysfunctional uterine bleeding (n= 37), adenomyosis with chronic pelvic pain (n= 13), and adnexal mass (n=6). Operation time was shorter for VH in comparison with TLH (108 ± 38.3 minutes versus 151 ± 41.5; p < 0.001). Delta hemoglobin was smaller for TLH in comparison with VH (1.7 ± 0.98 versus 2.8 ± 1.03; p < 0.001). Intraoperative complications and postoperative complications were comparable (p = 0.16 and p= 0.25; respectively). Postoperative hospital stay was shorter in TLH group compared to VH group (p < 0.001). Conclusion: Although VH is the suggested approach for the removal of uterus in literature, this study showed the non-inferiority of TLH against VH.