A Comparative Study of Abdominal Hysterectomy versus Vaginal Hysterectomy in Non Descent Cases

Abstract

Abdominal and vaginal hysterectomies are the two main operative modalities for various uterine conditions; however the indications for selecting a particular procedure in any setting may not be optimally defined. The present study was done with the objective to study the comparative risks of complications of abdominal and vaginal hysterectomies during intra-operative and post-operative period thereby improve the proportion of hysterectomies done vaginally. This randomized comparative study was carried out in the Department of Gynaecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University, during the period from January 2012 to December 2012. Sixty subjects were equally divided into vaginal hysterectomy (Group A) and abdominal hysterectomy (Group B), thirty in each group for non-prolapsed cases with good uterine mobility and uterine size less than 12 weeks. Intra-operative blood loss, mean operating time was more in Group A than in Group B (250 ml, 72.97 ± 9.27 min) and (200 ml, 55.27 ± 1.80 min) respectively. Postoperative fever (17% & 7%), bleeding requiring transfusion (72% & 28%) and abdominal wound infection (13%, 0%) was more common in Group A as compared to Group B. From the study results it can be concluded that patients requiring hysterectomy for benign non prolapsed cases be offered the option of vaginal route which is less invasive, minimal or no complications, more economical and effective. In our centre, it is likely to replace abdominal hysterectomy as the operation of choice.