Vaginal hysterectomy in patients with pelvic organ prolapse: An eight-year experience from a tertiary care center.

OBJECTIVE

Pelvic organ prolapse (POP) impairs quality of life in aging women. Vaginal hysterectomy (VH) is a standard approach for advanced POP, yet large single-center series are limited. We evaluated concomitant procedures and perioperative outcomes of VH and explored associations of age, parity, and concomitant adnexal or reconstructive surgery with perioperative measures.

STUDY

DESIGN

This retrospective cohort included 416 patients who underwent VH for POP between 2017 and 2025. Demographics, prolapse stage, concomitant procedures, perioperative complications, length of hospital stay, perioperative hemoglobin change, and pathological/specimen characteristics were recorded. Subgroup analyses compared patients undergoing additional reconstructive and/or adnexal surgery. Statistical analyses included t-test/ANOVA and Spearman correlation, with p < 0.05 considered statistically significant.

RESULTS

Mean age was 62.6 ± 9.2 years and mean parity 3.2 ± 1.7. POP was stage 3 in 41.6% and stage 4 in 34.6%. Anterior colporrhaphy was performed in 69.7%. Apical suspension accompanied VH in 72.4% of cases, including McCall culdoplasty (52.4%) and sacrospinous fixation (20.2%). Increasing age was associated with higher prolapse stage (p = 0.033). Vaginal deliveries were associated with cystocele and rectocele (p = 0.027 and p = 0.028). Concomitant adnexal surgery was associated with longer hospitalization and lower postoperative hemoglobin (p < 0.001 and p = 0.03). Postoperative complications occurred in 1.4% and were associated with lower mean age (p = 0.038).

CONCLUSIONS

VH for advanced POP demonstrated favorable perioperative outcomes with a low complication rate. Age, parity, and concomitant procedures influenced perioperative measures, supporting VH with apical suspension as a reliable real-world surgical option.