The Pryor technique of uterine morcellation

Objective: An efficient, yet largely forgotten technique of transvaginal uterine wedge morcellation developed by William Pryer at the turn of the century is described. Method: Pryer's technique of transvaginal wedge morcellation was employed to reduce uterine size in four cases of vaginal hysterectomy and in 10 cases of laparoscopic-assisted vaginal hysterectomy in 14 patients with symptomatic uterine enlargement. Result: Operating time ranged from 49-170 min (mean 92 min). Estimated blood loss ranged from 150 to 480 ml (mean 225 ml). Uterine size ranged from 360-710 g (mean 455 g). No procedure required conversion to laparotomy. Primary indications for preliminary laparoscopy were confirmed in nine of 10 cases. No vaginal hysterectomy required subsequent laparoscopy. No patient required blood transfusion. No intra-or post-operative complications were noted. All patients were discharged home within 48 h post-surgery. Conclusion: Pryer's technique of wedge morcellation appears to be a safe and efficient method for the reduction of uterine size transvaginally. (C) 1997 International Federation of Gynecology and Obstetrics.