Total abdominal hysterectomy at abdominal sacrovaginopexy: a comparative study

This study was designed to address whether women undergoing total abdominal hysterectomy at the time of abdominal sacrovaginopexy have a higher incidence of early postoperative febrile morbidity defined as an oral temperature > 35 degrees C (101 degrees F) on at least two occasions in the first 5 postoperative days when compared with women undergoing abdominal sacrovaginopexy alone.

A prospective cohort study was performed in a tertiary care gynecologic urology clinic. Two hundred thirty-five patients were included in this study. Eighty-six (36.6%) underwent total abdominal hysterectomy in addition to abdominal sacrovaginopexy, whereas 149 (63.4%) had abdominal sacrovaginopexy alone, according to a standard protocol. Data were collected by chart review and analyzed with odds ratio and Student t statistics.

The incidence of febrile morbidity was 4.7% in the group undergoing hysterectomy and 5.4% in the group having only abdominal sacrovaginopexy. The generated odds ratio (95% confidence interval) is 0.86 (0.21 to 3.28), which suggests no significant increase in febrile morbidity in the hysterectomy group. Similarly, no obvious difference was found in the duration of hospitalization or the change in hemoglobin between groups. There was, however, a significantly increased operating time in those patients undergoing hysterectomy.

Total abdominal hysterectomy performed at the time of abdominal sacrovaginopexy does not result in a clinically significant increased risk of febrile morbidity.