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ORIGINAL ARTICLE
Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 150-154

Risk factors associated with perineal and vaginal lacerations and vaginal removal in total laparoscopic hysterectomy


Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, Japan

Correspondence Address:
Dr. Kenro Chikazawa
Department of Obstetrics and Gynecology, Saitama Medical Center, The Jichi Medical University, 1-847, Amanuma-Cho, Omiya-Ku, Saitama 330-8503
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gmit.gmit_118_21

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Objectives: This study aimed to identify risk factors associated with perineal and vaginal lacerations related to vaginal removal during total laparoscopic hysterectomy (TLH). Materials and Methods: We retrospectively assessed 134 patients who underwent TLH, of whom 44 (32.8%) had vaginal lacerations. Results: Univariate analysis revealed that for patients with myomas and adenomyosis, gonadotropin-releasing hormone agonist use and myomas with a transverse diameter of ≥5 cm were significant risk factors, while multiparity (vaginal delivery) was a protective factor for perineal and vaginal lacerations. Moreover, multivariate analysis indicated that multiparity was the only statistically significant protective factor. For cervical intraepithelial neoplasia, endometrial cancer, and endometrial hyperplasia, only a uterine transverse diameter of ≥5 cm was a significant risk factor for perineal or vaginal lacerations. Conclusion: For patients with large myomas, multiple vaginal delivery was a protective factor, and in patients with normal-sized uteri, a uterine transverse diameter of ≥5 cm was a risk factor for perineal or vaginal lacerations.


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