Usha Nair (56) got an ultrasound done on the recommendation of her gynecologist when she experienced bleeding after attaining menopause. On the basis of her symptoms and further tests Dr Rinku Sengupta, Consultant Obstetrician – Gynecologist at Sitaram Bhartia Hospital suggested an NDVH.
Unaware to what this meant, Usha quickly asked,
“What is NDVH surgery? What is the full form of NDVH?”
In response, Dr Rinku informed her, “ NDVH or non-descent vaginal hysterectomy means the removal of the uterus from the woman’s body through the vagina instead of the abdomen.”
Is a hysterectomy a major surgery?
Like any surgery, a hysterectomy is a major operation.
“We recommend a hysterectomy in conditions where non-surgical treatments have not helped and only when women have completed their family and do not want more children.”
There are different types of hysterectomy such as
- Total hysterectomy wherein the uterus and cervix are removed
- Subtotal hysterectomy in which only the uterus is removed
How is the uterus removed by surgery?
The doctor went on to elaborate that a hysterectomy can be performed in three ways: abdominally, vaginally and laparoscopically. In an open abdominal hysterectomy, cuts or incisions are made on the abdomen and the reproductive organs are then drawn out.
When laparoscopic instruments are used to remove the uterus through small incisions, it is called a laparoscopic hysterectomy. A vaginal hysterectomy is usually done in the case of uterine prolapse-meaning the uterus has descended into the vagina. A non-descent vaginal hysterectomy (NDVH) is a type of vaginal hysterectomy that can be performed in the case of a non-prolapsed uterus.
Which surgery is best for uterus removal?
Vaginal hysterectomy when technically possible is the best route for the removal of uterus as it is done through a natural opening and there are no cuts or incisions. But when the vaginal route if not technically possible, then the laparoscopic route is preferred as it involves very small incisions on the abdomen.
When the uterus is very large or if ovarian disease coexists then sometimes even a laparoscopic hysterectomy may be difficult and an open surgery is preferred.
Which conditions require NDVH surgery?
Your gynecologist may suggest the NDVH surgery procedure in case of
“A non-descent vaginal hysterectomy (NDVH) requires skill, expertise and practice to remove the uterus through the natural hole in the vagina.”
Usha wanted to know the pros and cons of the procedure before considering it.
Advantages of NDVH surgery
NDVH in gynaecology is a common procedure that is nearly painless and smoother than a laparoscopy. The benefits of NDVH are:
- No stitches/scars, meaning it is a scarless surgery
- Few complications
- Short hospital stay and fast recovery
- Less pain after surgery
- Less expensive than other hysterectomies
Usha wanted to know how long it would take for her to return to her desk job after the surgery.
How long does it take to recover after NDVH?
You will need to stay in the hospital for 2 to 3 days. After your hospital stay, you will be able to go back home without requiring support.
“You can resume your daily chores, walk or climb stairs as usual.”
As a non-descent vaginal hysterectomy is a surgery like any other surgery, it involves risks like bleeding or infection.
“In the hands of an experienced gynecologist, you should have no reason to worry.”
Now free from doubt, Usha wanted to know if there were any instructions to keep in mind while getting ready for the procedure.
How do I prepare for NDVH?
- Take medicine as advised by your surgeon and anesthesiologist
- Avoid milk or food 8 hours prior to the scheduled time of surgery/procedure. You may drink water till 3 hours prior to the surgery/procedure.
- Contact your doctor immediately if you have a cough, cold, nasal congestion, fever, vomiting, and/or any other discomfort before admission.
- Ensure you bathe with soap and water, and wash your hair with shampoo before admission. Cut your finger and toe nails.
- On the day of the surgery, avoid wearing any jewellery/make up like nail paint, eye liner
- Bring the necessary documents as recommended by hospital staff.
“You will undergo a pre-anesthetic check up before surgery in which an anesthetist will inform you about the surgery and explain the options for anesthesia so you have a good understanding of what to expect,” said Dr Rinku.
With a thorough explanation and with all her questions addressed, Usha felt ready to undergo surgery. She discussed the procedure with her husband and children and then scheduled NDVH surgery for the following week.
She was discharged within two days and came in for a follow up visit shortly after.
“I was afraid when the doctor mentioned surgery but the way she explained the procedure and why it was being done gave me clarity on what to expect. I experienced pain only for 24 hours after the surgery and thereafter, didn’t face any discomfort. I’ve resumed my routine and feel a lot better,” Usha completed.
This article was written in Feb 2020 with editorial inputs from Dr. Rinku, Consultant, Obstetrics and Gynecology at Sitaram Bhartia Hospital.
Dr. Rinku Sengupta, MBBS, Lady Hardinge Medical College, University of Delhi (1991); MD, Obstetrics & Gynaecology, University College of Medical Sciences, University of Delhi (1997)
Come in for a complimentary consultation with Dr. Rinku. Please call on +91 9871001458 to schedule a free consultation.