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Abdominal hysterectomy versus non-descent vaginal hysterectomy- A comparative clinico-pathological study

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Original Article

Author Details : Pooja Gupta Jain, Smriti Singhal, Priyanka Pandey, Meena Bhargava

Volume : 4, Issue : 1, Year : 2017

Article Page : 59-65

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Abstract

Introduction: Hysterectomy is the commonest major operation performed by gynaecologist through various approaches and techniques including vaginal, abdominal, laparoscopic and robotic hysterectomy. Vaginal hysterectomy offers lesser complications during intra and post-operative period in comparison to abdominal hysterectomy. The past years have seen growing indications for vaginal hysterectomy and with the help of debulking techniques hysterectomy through vaginal approach become easier in large size uterus and now has been preferred over abdominal hysterectomy.
Objectives: The objectives of the study are to compare intra and post-operative complications, efficacy of abdominal hysterectomy with vaginal hysterectomy.
Methodology: A total of 170 cases with an indication of hysterectomy were selected of which 85 underwent Non descent vaginal hysterectomy and rest 85 underwent abdominal hysterectomy. These patients were further evaluated and statically analysed for various factors including age, parity, operative time, blood loss and intra and post-operative complications. Collected data were analysed.
Results: No significant association was found between age, parity and selection of procedure. Fibroid was the most common indication for hysterectomy in both the groups. Patients of NDVH group were operated with minimal blood loss, in lesser duration in comparison to patients operated by abdominal hysterectomy. Significant association was found for above two factors which highly influence the selection of procedure. 7.1% cases of NDVH required debulking procedure. Blood transfusion (17.6%), difficulty in opening the anterior pouch (24.7%), difficulty in delivery of the uterus (15.3%) was more in control group as compared to study group. post-operative complications were more in control group as compared to the study group like resuturing (4.7%), wound infection (9.4%), gastro-intestinal discomfort (15.3%), fever (17.6%) and abdominal distension (14.1%) which was significant. Faster recovery was observed in group of NDVH. Follow-up complications like vaginal discharge/UTI were almost equal in both the groups.
Conclusion: Non descend vaginal hysterectomy offers several benefits over abdominal surgery in terms of Less intra-operative blood loss, less febrile morbidity, low postoperative complications, faster recovery, less hospital stay, thus demonstrating that the vaginal route should be the choice of operation for non-descent cases.

Keywords: Hysterectomy, Vaginal hysterectomy, Abdominal hysterectomy

How to cite : Jain P G, Singhal S, Pandey P, Bhargava M, Abdominal hysterectomy versus non-descent vaginal hysterectomy- A comparative clinico-pathological study. Indian J Obstet Gynecol Res 2017;4(1):59-65

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