A retrospective study of laparoscopic-assisted vaginal hysterectomy (LAVH) in virgins and nulliparae.

Objective: To study the feasibility and result of LAVH performed in virgins and nulliparae.

Study Design: Retrospective review of 297 consecutive cases of LAVH using the Biswas Uterine Vaginal Elevator (BUVE) in a private hospital in Hong Kong for benign gynaecological conditions between July 2006 and February 2009. Variables analysed included patient demographics, operative times, uterine weight, hospital stay, intraoperative blood loss, and operative complications. Patients who were virgins and nulliparae were compared to each other and to a control group of patients receiving LAVH during the same period of time.

Results: All 297 cases of LAVH were successfully performed without any conversion. Ninety-seven LAVHs were performed on 31 virgins and 66 nulliparae, while 200 LAVHs were performed on parous patients during the same study period. The uterine sizes in the virgin group were significantly larger than those in the other two groups. The operation times in the virgin and nullipara groups were significantly longer than those in the control group. The complication rates of LAVH in these three groups were 6.4%, 12.1% and 3% in the virgin, nulliparous and control groups respectively. The overall complication rate of this series was low at 5.3%.

Conclusions: LAVH is feasible with acceptable safety in virgins and nulliparae in spite of their narrow and tight vaginas.