Vaginal hysterectomy vs abdominal hysterectomy

This was a prospective study, conducted to analyze the intraoperative complications, postoperative morbidities and complications between abdominal and vaginal hysterectomy. This study was carried out on 100 patients (50 cases abdominal and 50 cases vaginal hysterectomy), in Services Hospital, Lahore in the year 2002 from April to December. Among the intraoperative observation, the mean duration of surgery of abdominal hysterectomy was 96.8 min and that of vaginal was 89 min (p=0.0192). The mean blood loss in abdominal hysterectomy was 311 ml and that in vaginal hysterectomy was 244ml (p=0.0017). Postoperatively febrile morbidity was seen in 10 (20.0%) cases of abdominal hysterectomy group and 6 (12.0%) of vaginal hysterectomy group. Wound infection was the main cause for febrile morbidity in abdominal hysterectomy group where as urinary tract infection was the main cause for febrile morbidity in vaginal hysterectomy. There was one case of bladder injury and 1 case of ureteric injury in abdominal hysterectomy group while none in vaginal hysterectomy group. There were 2 (4.0%) cases of postoperative haemorrhage in abdominal hysterectomy group and none in vaginal hysterectomy group. Vault infection occurred in 2 (4.0%) cases of both the groups. Two (4.0%) cases of paralytic ileus, 2 (4.0%) cases of chest infection and 1 (2.0%) case of rectal muscle hematoma were seen in abdominal hysterectomy group. Overall 39 (78.0%) cases of abdominal hysterectomy and 1 (32.0%) case of vaginal hysterectomy had complications (p=0.0002). This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative morbidities and complications as compared to abdominal hysterectomy.