COMPARISON OF VAGINAL AND ABDOMINAL HYSTERECTOMY: PERI- AND POST-OPERATIVE OUTCOME
AbstractBackground: Abdominal and vaginal hysterectomies are the two predominant operativemodalities for various uterine conditions; however the indications for selecting a particularprocedure in any setting may not be optimally defined. This study was undertaken to evaluate theappropriate route of hysterectomy (abdominal or vaginal) in a hospital population for women withbenign disease by comparing peri-operative and post-operative complications. Methodology: Thisquasi-experimental study was undertaken at the Department of Obstetrics and Gynaecology, FaujiFoundation Hospital/Foundation University Medical College, Rawalpindi from January toDecember 2007. Eighty subjects were equally divided into vaginal and abdominal hysterectomygroups by convenience (non-probability) sampling. The primary outcome measures were operativetime, primary haemorrhage, wound infection, post-operative analgesia, febrile morbidity, hospitalstay and secondary haemorrhage; secondary outcome measure were estimated cost, re-admissionand reopening. Results: There were no differences in the patients’ mean age, parity, body massindex, and preoperative haemoglobin levels between groups. Vaginal hysterectomy was associatedwith less febrile morbidity, wound infection operative time, economic cost, bleeding requiringtransfusion and re-admission than abdominal hysterectomy. Main indication for women havingabdominal operation was leiomyomas, whereas more women having uterovaginal prolapse hadvaginal hysterectomy. Conclusion: Patients requiring a hysterectomy for benign lesions having amoderate-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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