Audit of Vaginal Route and Abdominal Route of Hysterectomy at a Tertiary Care Hospital

Abstract

Background: Hysterectomy is “Surgical removal of all or part of uterus”. Abdominal and vaginal route of hysterectomies are both predominant operative techniques being employed by the gynecologists all the world for various uterine conditions. Indications to select any particular technique in any of the hospital setting might not be optimally defined. This study was planned to evaluate particular route of hysterectomy (vaginal hysterectomy and abdominal hysterectomy) as there was no such study available which could document the data of our local population so this study was planned to be conducted to determine burden of problem and deficiencies for clinicians to opt better treatment options among targeted population. The results of this study will not only add in national data but will also be comparable with other international studies. Objective: To determine mean duration of surgery, mean duration of hospital stay and post-operative pyrexia in vaginal route and abdominal route of hysterectomy. Material and methods: A total of 240 women meeting inclusion and exclusion criteria of this study were registered in this study. Informed consent was taken from each patient. All the relevant data were recorded on pre-designed proforma. Data were entered and analyzed using SPSS-17. Results: A total of 240 subjects fulfilling the inclusion and exclusion criteria were registered in this study for abdominal hysterectomy and vaginal hysterectomy. Out of these 240 cases, 79 (32.9%) had undergone vaginal hysterectomy and 161 (67.1%) underwent through abdominal hysterectomy. Mean age of the study cases was 42.72±5.18 years (minimum age was 31 years while maximum age was up to 50 years). Mean parity of the study cases was 5.67±2.08 (minimum para 1 and maximum para 10). Pyrexia was seen in 90 (37.5%) of the study cases, of these 27 (30%) had undergone through vaginal hysterectomy and 63 (70%) underwent abdominal hysterectomy. Minimum duration of the surgery was 45 minutes and maximum duration of the surgery was 90 minutes, mean duration of the surgery was 69.75±14.92 minutes. Minimum Hospital stay was 3 days ranging to maximum hospital stay being 10 days, mean hospital stay in these study cases was observed to be 4.42±1.65 days. Conclusion: Vaginal route of hysterectomy is associated with lesser postoperative complications in terms short duration surgery, significantly short hospital stays and lower rates of postoperative pyrexia than that of abdominal route of hysterectomy.

Keywords: Abdominal Hysterectomy, Vaginal hysterectomy, Uterovaginal prolapse.