Vaginal hysterectomy for benign disorders in obese women: a prospective study

Objective To compare the morbidity of vaginal hysterectomy in obese and non‐obese women in a single institution. Design Obese and non‐obese women with benign uterine disorders matched for age, parity and race underwent vaginal hysterectomy without laparoscopic assistance. Peri‐operative outcome complications were compared. Thirty‐eight women had a BMI over 30 kg/m 2 (study group) and 178 women had a BMI below 30 kg/m 2 (control group). Setting Gynaecologic department of a university hospital. Population Women who were referred to our department with an indication of vaginal hysterectomy for benign disorders. Methods Case control study. Main outcome measures Peri‐operative complications, the fall in the haemoglobin concentration, the duration of the procedure, the length of the hospital stay and uterine weight were analysed. Results Mean BMI was 33.2 and 23.7 kg/m 2 in the study and control groups, respectively. None of the obese women had severe co‐morbidity contraindicating surgery. There were no significant differences in surgical or anaesthetic risk factors, including parity, hormonal status, pre‐existing disease and estimated mean uterine weight. The overall complication rates were 14% and 16% in the obese and non‐obese groups, respectively ( P = 0.7). Obesity did not increase the duration of the procedure (48 [7] minutes vs 50 [10] minutes, P = 0.1) or the length of hospitalisation (5.8 [1.4] days vs 5.5 [1.2] days, P = 0.2). Conclusion Vaginal hysterectomy can be successfully performed, with acceptable morbidity, in obese women.