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In this patient, mesh removal was done 4 months after meshplasty (Her initial surgery was NDVH with meshplasty).
In this study 56% of patients underwent AH, 20% had VH for prolapse, 13% had NDVH and 10% had LH (Table 1).
This indicates that both LH and NDVH can be performed safely even if the patient has been operated previously.
NDVH is associated with less handling of intestines, less exposure to general anaesthesia, no need of any specialized instruments, as compared to LH.
One of the 3 diabetics operated by NDVH had post-operative urinary tract infection, although all diabetics were controlled well by insulin.
In two patients with earlier lower segment caesarean section scar, NDVH had to be converted to open laparotomy due to uncontrolled intraoperative hemorrhage.
This is in accordance with our study, where previous LSCS led to adhesions and difficulty in achieving planes of dissection and laparotomy conversion of NDVH planned cases.
In our study the intra operative blood loss was significantly lower in LAVH than NDVH and AH (P <0.05).
Similarly in the study done by Roy et al, NDVH took least operative time and significantly less blood loss than TLH and NDVH in benign uterine conditions.
Among 5 cases of NDVH in which bladder injury occurred, all were repaired vaginally followed by hysterectomy by the same route.
Surgery Bladder Repair Post operative complication injury NDVH 4 Vaginal Nil NDVH [right 1 Vaginal Nil arrow] TAH TAH 2 Abdominal Nil VH 2 Vaginal Nil CS 3 Abdominal Leakage of urine in 1 Out of 3079 CS, 3 patients had bladder injuries which were repaired immediately.
The commonest mode of surgical approach in majority of the cases in our study was NDVH. Vaginal hysterectomy is associated with a shorter hospital stay and allows a faster recovery and healing.
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