Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 249-253, September 2009

Laparoscopically Assisted Vaginal Hysterectomy Following Previous Kidney Transplantation

  • Szu-Yu Chen

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • ,
  • Su-Cheng Huang

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • ,
  • Bor-Ching Sheu

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • ,
  • Daw-Yuan Chang

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • ,
  • Li-Yun Chou

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • ,
  • Wen-Chiung Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Buddhist Tzu Chi General, Taipei Branch, Taipei, Taiwan
    • ,
  • Wen-Chun Chang

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Branch, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wen-Chun Chang, Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan

Accepted 24 July 2008.

Article Outline

Summary 

Objective

With improvements in immunosuppression and surgical techniques, more women are undergoing kidney transplantation (KT) for management of end-stage renal disease. Location of the transplanted pelvic kidney and transplanted ureter must be taken into consideration when performing pelvic surgery. We demonstrate that laparoscopically assisted vaginal hysterectomy (LAVH) can be successfully performed in patients who had previously undergone KT.

Materials and Methods

We prospectively enrolled four patients requiring operation for symptomatic adenomyosis after KT. LAVH was performed in these cases after initial uterine artery ligation during laparoscopy.

Results

The median age of the patients was 44 years (range, 40–46 years) and the extirpated uterine weight was 195 g (range, 160–380 g). Intraoperatively, the median operation time was 147.5 minutes (range, 105–175 minutes) and the blood loss was 50 mL (range, 50–100 mL). There was mild pelvic adhesion in two cases. The postoperative recovery was good in all patients with oral intake, flatus passage, and ambulation within 1 day after operation. The median intramuscular meperidine requirements were 25 mg (range, 0–100 mg) and the hospital stay was 4 days (range, 3–8 days). There were no major complications in these cases except one with mild postoperative fever.

Conclusion

LAVH may be a safe and effective treatment for treating patients with adenomyosis after KT.

Key Words:  adenomyosis , kidney transplantation , laparoscopically assisted vaginal hysterectomy , uterine artery ligation

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PII: S1028-4559(09)60298-9

doi:10.1016/S1028-4559(09)60298-9

Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 249-253, September 2009

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