Laparoscopic or vaginal hysterectomy in women with abnormal uterine bleeding: A critical review of literature

Abstract

Background: Hysterectomy is a major gynecological surgery. The surgical approach to hysterectomy is an important factor responsible for postoperative morbidity. Minimally invasive hysterectomies are preferred routes over the routine abdominal approach.Objectives: To review the literature about the bases of choice between laparoscopic and vaginal hysterectomy routes for benign lesions and critically analyzes the different intra-operative and post-operative characteristics of these approaches in cases with benign pathologies.Materials and Methods: Review of previously published articles in the English language only.Results: No differences were found between laparoscopic and vaginal hysterectomies concerning their benefits and surgical outcome. However, LH is considered a longer operation and is associated with a higher cost and risks of urinary tract injuries. Management of adnexal pathologies is sometimes not applicable in cases of vaginal hysterectomy.Conclusion: Surgeons should minimize abdominal hysterectomy rates by applying minimally invasive approaches. The vaginal approach is the preferred evidence-based recommended approach in patients with benign pathologies. The laparoscopic approach is recommended in cases where a vaginal route isn’t applicable