Vaginal hysterectomy safe despite prior uterine surgeries in one patient series. (One Surgeon's Experience).

St. Louis -- Previous uterine surgery is often cited as a contraindication to vaginal hysterectomy--but it needn't be, according to Dr. Stephen L. Larson.

This is a point particularly deserving of emphasis in light of rising cesarean section rates, he noted at the 12th International Pelvic Reconstructive and Vaginal Surgery Conference.

Dr. Larson has performed 1,651 hysterectomies during a 15-year period in his Minneapolis private gynecologic practice, of which almost 76% were accomplished vaginally That's exactly opposite the national pattern, in which three-quarters of all hysterectomies are done abdominally, with significantly greater patient morbidity and slower recovery.

A total of 184 of Dr. Larson's vaginal hysterectomies were accomplished in women with prior myomectomy, uterine suspension, or cesarean section, including 101 patients who had two to five prior C-sections.

Vaginal hysterectomy can be "a real dogfight," especially in patients who've had at least three prior C-sections, according to Dr. Larson. He made frequent use of morcellation, employing it in 47 patients ...