OBJECTIVETo evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions.

METHODSOne hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group I contained 60 patients with uterine enlargement to a weight of 200 to 750 g, and group II contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The perioperative data in both groups were analyzed.

RESULTSIn group I, 59 cases underwent transvaginal hysterectomy successfully, except 1 case converted to abdominal operation and the uterine morcellation was performed in 21 women. In group II, all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group I was significantly heavier than that of group II (280.18 +/- 100.40 g vs 146.48 +/- 35.19 g). The mean operating time was significantly longer for group I than that for group II (83.93 +/- 26.26 minutes vs 35.22 +/- 20.55 minutes). There were no significant differences in blood loss and complications between group I and group II. There was no injury of urinary bladder or rectum, and no vaginal vault infection.

CONCLUSIONSVaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases, in order to reduce the uterine volume, uterine morcellation should be used to shorten operative time, reduce the bleeding, and lower the postoperative complications.