[Complications following vaginal hysterectomy]

The author analyses complications following 817 vaginal hysterectomies (VH). The mortality rate was 0.24%. Laparotomy during VH was performed in 3 patients (0.36%): twice the commenced VH was completed abdominally (once owing to the overlooked fixed uterus in a very obese patient and once owing to the previously performed Doleris operation). These are so-called unsuccessful vaginal hysterectomies. In the third patient laparotomy was applied owing to the bleeding from the retracted, cut uterine artery. Injuries of the urinary pelvis during the VH procedure occured in two patients: once during the opening of the plica vesico-urinaris and once during the opening of the Douglas sac (in the patient with a previous Doleris operation). Both injuries were cured vaginally. Early complication were recorded in 34.02% (278 cases). Most infections occurred in the small pelvis. Late complications were encountered in 41.07% (207 cases) out of 504 followed-up patients. Granulation tissue has proved to be the most frequent complication in this group of women (33.13%). Incontinentia urinae was found in 2.5% (13 cases).