A history of pelvic surgery has been a source of concern when considering a patient for vaginal hysterectomy. Postsurgical scarring and adhesions may produce relative fixation of the uterus or adherence of the urinary or intestinal tract with resultant predisposition to injury. The nature and relative risk of problems associated with some of the commonly encountered prior pelvic operations are discussed. Some methods of transvaginally managing a variety of potentially complicated postsurgical changes are described. When good uterine mobility and other anatomic factors favorable for vaginal hysterectomy are present, significant difficulties related to the prior pelvic surgery are unlikely. A cautious approach is of course warranted.
KeywordsMethylene Blue Obstet Gynecol Vaginal Hysterectomy Pelvic Surgery Sharp Dissection
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- 3.Nichols DH, Randall CL. Vaginal surgery (3rd ed). Maryland. Williams & Wilkins, Baltimore, 1989, p 186Google Scholar
- Bradford WZ, Bradford WB, Woltz JHE, Brown CW. Experiences with vaginal hysterectomy. Am J Obstet Gynecol 68:640–548, 1954Google Scholar
- Gray LA. Vaginal Hysterectomy, Charles C Thomas, Springfield, IL, 1955, pp 47–48Google Scholar
- Isaacs JH. Vaginal hysterectomy. In Sciarra JJ, Droegemueller W (eds). Gynecology and Obstetrics (vol 1). Lippincott, Philadelphia, 1990, p 1Google Scholar
- Kaser O, Iklé FA, Hirsch HA. In Friedman EA (ed). Vaginal hysterectomy and vaginal procedures for uterine descensus. Atlas of Gynecologic Surgery (2nd ed). Thieme-Stratton, New York, 1985Google Scholar
- Wheelock JB, Krebs HB, Hurt WG. Sparing and repairing the bladder during gynecologic surgery. Contemp Obstet Gynecol 28:163–171, 1984Google Scholar