Publication:

Abdominal versus vaginal hysterectomy in non-descent cases

Background Hysterectomy is the most frequently performed elective major operation in gynaecology by vaginal and abdominal route. Gynaecologic surgeons worldwide said that two are not competitive procedures but each one has its own place in the operative armamentarium. Present study is done to comparative risks of complications in abdominal route versus vaginal route of hysterectomy in intra operative and post-operative periods.

Methods It’s a retrospective study was  done from Dec 2013 - Dec 2014 for a period of one year in 82 women who had undergone hysterectomy, divided as group A with abdominal hysterectomies (44 cases) and group B with vaginal hysterectomies (38). Information on the indications, operative procedures, and complications were noted and analyzed.

Results Intra-operative blood loss, mean operating time was more in group A than in group B. The mean duration of surgery in group B was 76 ± 12 min and that of group B was 101 ± 14 min. The mean blood loss was also more in case of group A than that of group B (219 ml vs. 172 ml). Bladder injury occurred in 1 case in group B (3%) and in 3 cases in group B (7%). Ureter injury occurred in 1 (2%) case in group A. Postoperative fever (20% & 8%), UTI (13% & 11%) and wound infection (10%, 0%). Only one patient underwent relaparotomy for internal bleeding via abdominal route was more common in group A as compared to group B. Only one patient underwent re-laparotomy for internal bleeding via abdominal route.

Conclusions Study results conclude  that patients requiring hysterectomy for benign non prolapse cases be offered the option of vaginal route which is quicker recovery, early mobilization, shorter hospitalization, less operative and post-operative morbidity, more economical and effective.