{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:35:44Z","timestamp":1792193744971,"version":"4.4.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T00:00:00Z","timestamp":1355184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T00:00:00Z","timestamp":1355184000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Gynecologic Surgery"],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    <\/jats:bold>\n                    Vaginal hysterectomies have been associated with difficulties in patients who have had cesarean sections prior to such hysterectomies. However, the Purohit technique may obviate the problems and make it easier to perform these operations.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Objectives:<\/jats:italic>\n                    <\/jats:bold>\n                    This research tested an approach designed to facilitate vaginal hysterectomy in patients with previous cesarean sections in the absence of fixed adhesions of uterine corpi to previous anterior abdominal scarring.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Design\/Method<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">:<\/jats:italic>\n                    An observational study was conducted in a private general hospital between February 2010 and June 2012. All candidates for hysterectomy for benign indications who had had previous cesarean sections were examined for the presence of clinical and sonographic signs of fixed adhesions of uterine corpi to anterior abdominal-wall incisions caused by prior cesarean sections. Candidates who had such adhesions were not given vaginal hysterectomies.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    Sixty-four (64) consecutive candidates were selected for vaginal hysterectomies. Of these patients, 26 (40.62%) had 1 cesarean section, 33 (51.56 %) had 2 cesarean sections, and 5 (7.81%) had 3 cesarean sections. Four (4) patients had had prior pelvic operations. The uteri were smaller than 12 weeks' gestation-size in 62 (96.87%) cases. In 26 (40.62 %) cases, there were no obstruction to accessing the anterior\n                    <jats:italic toggle=\"yes\">cul-de-sacs<\/jats:italic>\n                    and vaginal hysterectomies were performed using the Purohit technique. In 38 (59.37 %) cases, dense uterovesical adhesions obstructed access to the anterior\n                    <jats:italic toggle=\"yes\">cul-de-sacs<\/jats:italic>\n                    and a posterioanterior approach was used to perform vaginal hysterectomy in these patients. Vaginal hysterectomy was completed in all 64 cases. Vaginal salpingo-oophorectomy was performed in 3 (4.68%) cases. The mean operative time was 78.59\u00b133.15 (35\u2013190) minutes. The mean weight of specimen uteri was 161.01\u00b1108.87 (50\u2013550) g. No patients needed conversions or blood transfusions. No patients had bladder, ureteric, or thermal injuries. Finally, there were no other major postoperative complications.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:bold>\n                    In the absence of fixed adhesions of the uterine corpus to previous anterior abdominal scarring, vaginal hysterectomy for benign indications associated with previous cesarean section may be accomplished safely. The posterioanterior approach during vaginal hysterectomy may avoid unintended bladder injury in the presence of dense uterovesical adhesions caused by previous cesarean sections. (J GYNECOL SURG 29:7)\n                  <\/jats:p>","DOI":"10.1089\/gyn.2012.0082","type":"journal-article","created":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T09:06:56Z","timestamp":1355216816000},"page":"7-12","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section"],"prefix":"10.1177","volume":"29","author":[{"given":"Ram Krishna","family":"Purohit","sequence":"first","affiliation":[{"name":"Purohit General Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay Gopal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Purohit General Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarabjeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Purohit General Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipak Kumar","family":"Giri","sequence":"additional","affiliation":[{"name":"Purohit General Hospital","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,12,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.07.090"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den467"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2009.11.007"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00484-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-0412.2003.00247.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2003.02427.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(95)02434-E"},{"key":"e_1_3_2_9_2","first-page":"217","article-title":"Urological complications of laparoscopic hysterectomy: A four year review at KK Women's and Children's Hospital, Singapore","volume":"48","author":"Siow A","year":"2007","unstructured":"Siow A, , Nikam YA, , Ng C. 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