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Evaluation of complications of abdominal and vaginal hysterectomy

N. Fatima Shanthini, G. K. Poomalar, M. Jayasree, A. Bupathy.

Abstract
Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologist. It can be performed by vaginal and abdominal route. Gynaecologic surgeons worldwide continue to use the abdominal approach for a large majority of hysterectomies that could be performed vaginally despite well-documented evidence that vaginal hysterectomy has better outcome. Aim of our study is to compare vaginal route versus abdominal route of hysterectomy in terms of intra operative and post operative complications.
Methods: A retrospective study was done in 229 women who had undergone hysterectomy (176 abdominal hysterectomies and 53 vaginal hysterectomies) from January 2010 to July 2012. Information on the indications, operative procedures, and complications were extracted and analysed.
Results: The mean duration of surgery in VH group was 79.6 min and that of TAH group was 99.2 min. The mean blood loss was also more in case of TAH group than that of VH group (215ml vs. 167ml). Bladder injury occurred in 1 case in VH (1.9%) and in 4 cases in TAH (2.3%). Ureter injury occurred in 1(0.6%) case in TAH group. Wound infection developed in 10 cases of TAH group whereas only one case in VH group developed vault infection.
Conclusions: Vaginal hysterectomy is associated with quicker recovery, early mobilization, shorter hospitalization, less operative and post operative morbidity when compared to abdominal hysterectomy.

Key words: Abdominal hysterectomy, benign uterine diseases, intra operative complications, post operative complications, vaginal hysterectomy


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