Aim: This trial was undertaken to assess the efficacy of electrosurgical bipolar clamping pedicles securing (BCPs) in comparison to clamping suturing pedicles securing (CSPS) in women undergoing non-descent vaginal hysterectomy (NDVH).
Patients and Methods: This was a prospective randomized trial conducted at Benha University Hospital. Forty two women were randomized to BCPS (no = 21) or CSPS (no = 21). Exclusion criteria were uterine size > 20 weeks gestation, Body mass index > 40 kg/m2 and uterovaginal prolapse of any degree. Main outcome measures were operative time, blood loss, hospital stay, pain status, peri and postoperative complications. Statistical analysis was done by Medcalc software bvba 2016.
Results: There were no differences in patients mean age, parity and uterine size between groups. Participonts in BCPS group had shorter total procedure time (62 min. vs 81 min. p= 0.031), shorter pedicles securing time (42 min. vs 61 min; P = 0.007), less blood loss (425 130 ml vs 550 150 ml, P = 0.006), less in postoperative HB and hematocrit (p = 0.019, P= 0.036) respectively, reduced postoperative pain status (46 32 vs 28 21, P < 0.037) and low requirement of surgical sutures (1.4 0.6 units vs 7.8 1.2 units, P < 0.0001) compared to participants in CSPS group. Complication rates were not statistically different between the two groups (P = 0.030).
Conclusion: The bipolar clamping pedicles securing technique is safe and effective alternative for pedicles securing in nondescent vaginal hysterectomy when compared to clamping suturing pedicle securing technique, with reduced total and pedicles securing operating time, perioperative blood losses and postoperative pain.
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