• Am. J. Obstet. Gynecol. · May 2011

    Meta Analysis Comparative Study

    Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials.

    • Rasha Gendy, Colin A Walsh, Stewart R Walsh, and Emmanuel Karantanis.
    • Faculty of Medicine, University of New South Wales, Sydney, Australia.
    • Am. J. Obstet. Gynecol. 2011 May 1; 204 (5): 388.e1-8.

    ObjectiveRecent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain.Study DesignThis study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Pooled outcome measures (odds ratio [OR] and weighted mean difference [WMD]) were calculated using random-effects models.ResultsNo differences in perioperative complications, either total (pooled odds ratio, 0.87; P = .74) or by grade of severity, were demonstrated. TLH was associated with reduced postoperative pain scores (WMD -2.1; P = .03) and reduced hospital stay (WMD -0.62 days; P < .0001) but took longer to perform (WMD 29.3 minutes; P = .003). No differences in blood loss, rate of conversion to laparotomy, or urinary tract injury were identified.ConclusionTLH may offer benefits compared with VH for benign disease, although this analysis is likely underpowered for rare complications. Further studies of long-term outcomes, including prolapse, urinary incontinence, and sexual function, are required.Copyright © 2011 Mosby, Inc. All rights reserved.

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