Abstract
Vaginal hysterectomy is a least invasive and the choicest route when hysterectomy is possible by recourse to all the three available techniques. However in obese women, the common method is by the more invasive abdominal or laparoscopic route, with attendant morbidity. Vaginal hysterectomy was reviewed in 102 morbidly obese women (body mass index, BMI ≥ 40) and compared with 50 comparable morbidly obese women who underwent abdominal hysterectomy and with vaginal hysterectomy in 200 normal weight women (BMI < 25). Time for vaginal hysterectomy was slightly but significantly longer in the morbidly obese compared to those of normal weight, while the abdominal approach was significantly longer in the morbidly obese. Hospital stay was significantly longer for the abdominal operations in the obese. Surgical and anesthetic complications did not differ. In the absence of specific contraindications for vaginal hysterectomy it is recommended that the surgeon should perform hysterectomy vaginally and consider obesity as a contraindication for taking the abdominal route.
Acknowledgements
The author thanks PM Bhujang, medical director of Sir Hurkisondas Hospital and Geeta Koppikar, medical director of Breach Candy Hospital, for permission to use hospital data and Anil Arekar for statistical analysis.
Disclosure of interest: The author reports no conflicts of interest. The author alone is solely responsible for the content and writing of the paper.