Abdominal, laparoscopic, and vaginal hysterectomy with bilateral salpingo-oophorectomy - A feasibility study for further evaluation in randomized trials

Background: The abdominal route is the traditional method of performing hysterectomy with bilateral salpingo-oophorectomy. In a feasibility study, we compared a nonconventional (vaginal) route for bilateral salpingo-oophorectomy at the time of vaginal hysterectomy (VH + BSO) to similar forms of hysterectomy performed abdominally or with operative laparoscopy, Methods: Fifty-nine patients were subject to either total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO; n = 19), or laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy (LAVH + BSO; n = 19) or VH + BSO (n = 21). Results: VH + BSO resulted in a shorter operating time compared to LAVH + BSO (p < 0.001), shorter hospital stay compared with TAH + BSO (p = 0.001), and quicker longterm recovery compared to the other two operations. Conclusion: This preliminary but significant study shows that the vaginal route for salpingo-oophorectomy at the time of vaginal hysterectomy is superior to other methods of hysterectomy. A randomized trial is needed to confirm these initial findings.