Hysterectomy Abdominal or Vaginal

Abstract

A descriptive crossectional comparative study was conducted & retrospective data collection was carried out in Department of Obstetrics and Gynecology Lahore General Hospital, Lahore. 285 hysterectomies were performed during the period from December 1996 to May 1998. Out of these 285 hysterectomies 190 were carried by abdominal route and 95 through vaginal rout (ratio is 1:2). The maternal age incidence showed that 55.8% of the patients undergoing abdominal hysterectomy were of the age between 30 to 49 years whereas 61% of patients undergoing vaginal hysterectomy were of the age between 50 to 60 years. On 12 cases (6.3%) abdominal hysterectomy was performed on nulliparous, whereas 74 cases (80%) operated for vaginal hysterectomy were grandmultips. Indications of hysterectomy were uterine myoma, utero-vaginal prolapse, dysfunctional uterine bleeding, endometriosis, pelvic inflammatory disease, malignant ovarian tumours and carcinoma endometrium. Commonest postoperative complication was haemorrhage in 9.3% of cases of abdominal hysterectomy and 7.3% cases of vaginal hysterectomy. Urinary tract infection in 6.3% cases of abdominal hysterectomy was observed and in 8.4% of vaginal hysterectomy. Wound became infected in 5.8% cases of abdominal hysterectomy and vault abscess/ haematoma in 3.1% cases of vaginal hysterectomy (p= .073, chi square 3.21, RR= 1.34). The mean postoperative hospital stay for abdominal hysterectomy was 7 days and in case of vaginal hysterectomy was three to four days. This study concludes that vaginal hysterectomy should be preferred over abdominal hysterectomy, where possible as it’s morbidity is much less than abdominal procedure.