A cohort study comparing laparoscopic-assisted vaginal hysterectomy and extrafascial hysterectomy.

Study Objective: To compare extrafascial hysterectomy (TAH) and laparoscopic-assisted vaginal hysterectomy (LAVH).

Design: Consecutive women scheduled for hysterectomy, who entered one group or the other based on personal preference.

Setting: A university-affiliated women's hospital.

Patients: Thirty-seven women with benign gynecologic pathology.

Interventions: Eighteen underwent TAH and 19 had LAVH. All were followed for 6 months postoperatively.

Measurements And Main Results: The duration of LAVH was significantly longer than that of TAH; estimated blood loss was significantly higher for TAH; and the duration of use of narcotic analgesics, length of hospital stay, and length of time to resumption of routine working activity were significantly shorter after LAVH. No difference was found in the two groups with respect to Q-Tip test preoperatively and 6 months after surgery.

Conclusions: We believe LAVH is a valid and safe alternative to TAH in selected patients. The two procedures do not alter the mobility of the bladder neck on short-term follow-up. Additional prospective studies are necessary to confirm our data.