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Deciding the Route for Hysterectomy: Indian Triage System

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Abstract

Objectives

To review the limitations, major complications, and conversion rates associated with non-descent vaginal hysterectomy (NDVH); and develop a scoring system to predict the possibility of successful NDVH.

Methods

The risk analysis of conversion rates from vaginal to abdominal route while attempting NDVH was applied to formulate a scoring system for the assessment of successful NDVH. Parameters were selected based on Kovacs guidelines to determine the route of hysterectomy.

Results

From April 2005 to December 2008, NDVH was attempted in 364/1,378 women undergoing hysterectomy for benign conditions (Gp-I). Eight out of 364 cases (2.1 %) either had to be converted to the abdominal route or had major complication. Endometriosis and repeated sections had the highest risk. Scoring system was developed based on the risk analysis. Validity of this scoring system was tested in 1,177 women from January 2009 to September 2012 (Gp-II). 460 women with a score of 16 or less underwent NDVH successfully with a conversion rate of 0.2 %.

Conclusion

Careful assessment by a simple scoring system can help in deciding the feasibility of performing NDVH.

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Compliance with ethical requirements and Conflict of interest

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in this study. Dr. Alokananda Ray, Dr. Luna Pant and Dr. Navneet Magon declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of OBGYN, Tata Main Hospital, Jamshedpur, India

    Alokananda Ray (Specialist)

  2. Department of OBGYN, Max Hospital, Dehradun, India

    Luna Pant (Head)

  3. Department of OBGYN, Air Force Hospital, Jorhat, India

    Navneet Magon (Head)

  4. 8D Road East Northern Town, Bistupur, Jamshedpur, 831001, Jharkhand, India

    Alokananda Ray (Specialist)

Authors
  1. Alokananda Ray
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  2. Luna Pant
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  3. Navneet Magon
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Corresponding author

Correspondence to Alokananda Ray.

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Ray, A., Pant, L. & Magon, N. Deciding the Route for Hysterectomy: Indian Triage System. J Obstet Gynecol India 65, 39–44 (2015). https://doi.org/10.1007/s13224-014-0578-4

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  • DOI: https://doi.org/10.1007/s13224-014-0578-4

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