COMPARISON OF VAGINAL AND ABDOMINAL HYSTERECTOMY: PERI- AND POST-OPERATIVE OUTCOME

Nasira Sabiha Dawood, Rabia Mahmood, Naila Haseeb

Abstract


Background: Abdominal and vaginal hysterectomies are the two predominant operative
modalities for various uterine conditions; however the indications for selecting a particular
procedure in any setting may not be optimally defined. This study was undertaken to evaluate the
appropriate route of hysterectomy (abdominal or vaginal) in a hospital population for women with
benign disease by comparing peri-operative and post-operative complications. Methodology: This
quasi-experimental study was undertaken at the Department of Obstetrics and Gynaecology, Fauji
Foundation Hospital/Foundation University Medical College, Rawalpindi from January to
December 2007. Eighty subjects were equally divided into vaginal and abdominal hysterectomy
groups by convenience (non-probability) sampling. The primary outcome measures were operative
time, primary haemorrhage, wound infection, post-operative analgesia, febrile morbidity, hospital
stay and secondary haemorrhage; secondary outcome measure were estimated cost, re-admission
and reopening. Results: There were no differences in the patients’ mean age, parity, body mass
index, and preoperative haemoglobin levels between groups. Vaginal hysterectomy was associated
with less febrile morbidity, wound infection operative time, economic cost, bleeding requiring
transfusion and re-admission than abdominal hysterectomy. Main indication for women having
abdominal operation was leiomyomas, whereas more women having uterovaginal prolapse had
vaginal hysterectomy. Conclusion: Patients requiring a hysterectomy for benign lesions having a
moderate-sized uterus can be offered vaginal route for surgery.
Keywords: Hysterectomy, Abdominal hysterectomy, vaginal hysterectomy, indications, postoperative outcome, post-operative complications

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