Personalised Surgical Care for Women’s Gynaecological Health.
Certain gynaecological conditions, such as persistent heavy menstrual bleeding, symptomatic uterine fibroids, and other uterine disorders, may require surgical treatment when medication or other conservative options have not provided sufficient relief.
At Nova Femina, Nagpur, we provide consultations for women exploring Non-Descent Vaginal Hysterectomy (NDVH) and other appropriate gynaecological treatment options. NDVH is a surgical technique in which the uterus is removed through the vagina, even when it has not descended or prolapsed.
Our approach focuses on understanding your condition, reviewing available treatment options, and determining whether vaginal hysterectomy is appropriate for your individual circumstances.
Led by Dr. Rucha Sanap Changle, Nova Femina is dedicated to personalised gynaecological care, with an emphasis on patient safety, privacy, and informed decision-making.
What Is Non-Descent Vaginal Hysterectomy?
Non-Descent Vaginal Hysterectomy, commonly known as NDVH, is a surgical procedure in which the uterus is removed through the vaginal canal without a planned abdominal incision.
Unlike vaginal hysterectomy performed for uterine prolapse, NDVH is considered when the uterus remains in its usual position. It may be an option for selected women who require hysterectomy for certain benign gynaecological conditions.
Because the procedure is performed through the vagina, it avoids a planned abdominal incision. However, it is not suitable for every patient, and the feasibility of the vaginal approach depends on factors such as uterine size, mobility, pelvic anatomy, previous surgery, and the underlying condition.
At Nova Femina, the appropriate surgical approach should be determined after an individual clinical assessment and discussion of alternatives.
When May NDVH Be Recommended?
NDVH may be considered for selected women with gynaecological conditions when hysterectomy is appropriate and the vaginal route is clinically suitable.
1. Persistent Heavy Menstrual Bleeding
Women experiencing heavy or prolonged menstrual bleeding that has not responded adequately to appropriate treatment may be evaluated for hysterectomy, depending on the underlying cause and their preferences.
2. Symptomatic Uterine Fibroids
Uterine fibroids are non-cancerous growths in or around the uterus. When fibroids cause significant bleeding, pressure, pain, or other symptoms, surgery may be considered if other treatments are unsuitable or unsuccessful.
3. Adenomyosis
Adenomyosis occurs when tissue similar to the uterine lining grows within the muscular wall of the uterus. It may contribute to painful periods, heavy bleeding, and pelvic discomfort. Hysterectomy may be considered for selected women whose symptoms remain troublesome despite appropriate treatment and who do not wish to preserve their ability to carry a pregnancy.
4. Other Selected Benign Uterine Conditions
Depending on the diagnosis, clinical findings, and previous treatment, hysterectomy may be considered for other non-cancerous uterine conditions when appropriate alternatives have been discussed. The vaginal route is not suitable for every condition requiring hysterectomy. Suspected or confirmed malignancy requires an appropriate specialist assessment and a procedure planned according to the diagnosis.
Potential Advantages of NDVH
When vaginal hysterectomy is appropriate, the procedure may offer several advantages compared with abdominal hysterectomy.
- No planned abdominal incision: The uterus is removed through the vagina.
- No external abdominal scar from the vaginal approach: The operation does not require a conventional abdominal incision.
- Potentially shorter recovery: Some women recover more quickly than after abdominal hysterectomy.
- Less abdominal wound discomfort: Avoiding an abdominal incision may reduce discomfort associated with an abdominal wound.
- Individualised surgical care: The route of surgery can be selected according to the patient's anatomy, condition, and clinical needs.
These advantages are not guaranteed for every patient. Outcomes depend on the procedure, individual health, and whether complications or additional surgical requirements arise. Occasionally, the surgeon may need to change the planned approach for safety reasons.
Who May Be Suitable for NDVH?
Suitability depends on several clinical factors, including:
- The size, shape, and mobility of the uterus.
- The nature and severity of the underlying uterine condition.
- Previous pelvic or abdominal surgeries.
- The presence of other pelvic conditions.
- The patient's general health and surgical risk.
- Whether the vaginal route allows the procedure to be performed safely.
A gynaecological assessment helps determine whether NDVH, laparoscopic hysterectomy, or abdominal hysterectomy is the most appropriate approach.
How Is NDVH Performed?
1. Initial Consultation
Your consultation begins with a discussion about your symptoms, medical history, previous treatments, and expectations.
2. Clinical Evaluation
Your doctor reviews the diagnosis and may recommend a pelvic examination, ultrasound, blood tests, or other investigations depending on the underlying condition.
3. Personalised Surgical Planning
If hysterectomy is appropriate, your doctor will explain the available surgical routes, their potential benefits and risks, and any suitable alternatives. You will also discuss whether the cervix, fallopian tubes, or ovaries are to be removed. These decisions depend on the diagnosis, individual risk factors, and the agreed surgical plan.
4. The Surgical Procedure
NDVH is performed under an appropriate anaesthesia plan. The surgeon accesses the uterus through the vagina, separates it from its supporting structures and blood supply, and removes it through the vaginal canal. The exact technique depends on the patient's anatomy and clinical circumstances.
5. Postoperative Care and Follow-Up
After surgery, your clinical team will monitor your recovery, pain control, mobility, and ability to pass urine. Follow-up appointments help assess healing and address any concerns.
What Changes After a Hysterectomy?
Hysterectomy is an irreversible operation, so understanding its implications is essential before proceeding.
- Menstruation stops: Once the uterus is removed, menstrual periods no longer occur.
- Pregnancy is no longer possible: You cannot carry a pregnancy after hysterectomy.
- Ovarian function may continue:If the ovaries are retained, they may continue producing hormones until natural menopause.
- Menopause may occur immediately if both ovaries are removed: Removal of both ovaries before natural menopause causes surgical menopause and may require additional counselling about symptom management and hormone therapy.
- Recovery varies: Healing depends on the procedure, the underlying condition, and individual health.
Your doctor should discuss these implications and any concerns about fertility, hormonal health, or sexual wellbeing before surgery.
Why Choose Nova Femina?
1. Specialised Gynaecological Care
A focused approach to cosmetic and reconstructive gynaecology, guided by individual clinical needs.
2. Personalised Treatment Planning
Treatment recommendations based on your symptoms, anatomy, medical history, and expectations.
3. Privacy and Confidentiality
A respectful clinical environment where intimate health concerns can be discussed openly and discreetly.
4. Care Beyond Surgery
Clear communication, personalised aftercare guidance, and follow-up support throughout your treatment journey.
Recovery After NDVH
Recovery varies according to your health, the reason for surgery, the extent of the procedure, and whether any complications occur. During recovery, you may experience temporary discomfort, tiredness, and light vaginal bleeding or discharge.
Your surgeon will provide guidance regarding:
- Wound care and personal hygiene.
- Gradually returning to everyday activities.
- Avoiding heavy lifting and strenuous exercise during the recommended recovery period.
- When sexual activity can safely resume.
- Follow-up appointments and any further treatment required.
Seek prompt medical attention if you experience heavy bleeding, fever, worsening abdominal pain, difficulty passing urine, foul-smelling discharge, or other concerning symptoms.
Understanding the Risks
Like any major operation, NDVH carries potential risks. These may include:
- Bleeding or infection.
- Injury to the bladder, ureters, bowel, or surrounding structures.
- Blood clots.
- Anaesthesia-related complications.
- Difficulty passing urine or other urinary symptoms.
- Vaginal cuff complications if the cervix is removed.
- The possibility of changing to another surgical approach if required for safety.
The likelihood of complications depends on individual health, anatomy, the underlying condition, and surgical complexity. Your treating surgeon should explain the specific risks and alternatives before obtaining informed consent.
Why Choose Nova Femina?
1. Personalised Gynaecological Care
Treatment recommendations based on your diagnosis, symptoms, medical history, and individual needs.
2. Individualised Surgical Planning
A careful discussion of the appropriate surgical route and available alternatives.
3. Privacy and Confidentiality
A respectful environment where you can discuss sensitive gynaecological concerns comfortably.
4. Informed Decision-Making
Clear explanations of the procedure, its irreversible implications, potential risks, and expected recovery.
5. Care Beyond Surgery
Appropriate postoperative guidance and follow-up to monitor healing and address concerns.
Consult for NDVH in Nagpur
If you have been advised to consider hysterectomy or are exploring surgical options for a persistent uterine condition, a specialist consultation can help you understand the available approaches.
At Nova Femina, Nagpur, you can enquire about a consultation with Dr. Rucha Sanap Changle to discuss your condition and explore appropriate gynaecological treatment options.
Understand your diagnosis. Explore your options. Make an informed decision.