Objective: To compare perioperative surgical, medical, and financial outcomes in morbidly obese women with body mass index (BMI) ≥ 40 kg/m2 who underwent non-descent vaginal hysterectomy (NDVH) compared to total abdominal hysterectomy (TAH) for non-prolapse indications.
Patients and methods: A retrospective observational cohort analysis included 117 morbidly obese women who underwent hysterectomies performed between January 2015 and March 2023 in Benha university hospital comparing the outcomes between NDVH and TAH. The NDVH group (index group) included 55 morbidly obese women who underwent total vaginal hysterectomy (TVH) for non-prolapse indications. The TAH group (control group) included 62 morbidly obese women who underwent total abdominal hysterectomy for non-prolapse indications. Both groups were compared as regards pre-, intra-, and post-operative demographic, clinical characteristics, total costs and complications.
Results: Both NDVH and TAH groups participants had statistically indifferent pre-operative mean hemoglobin levels, age, parity, associated comorbidities, previous pelvic and abdominal surgery involving cesarean sections, and comparable indications for hysterectomy(p>0.05), but statistically higher BMI (51.6 kg/m2 in NDVH vs 46.3 kg/m2 in TAH, P=0.0001), HBA1c preoperative serum level