Non-Descent Vaginal Hysterectomy Versus Total Abdominal Hysterectomy-A Case Control Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 12
Abstract
Background: 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. Vaginal route for non descent uterus is acceptable method of hysterectomy in selected cases and with the help of debulking technique it becomes easier in large size uterus also. Objectives: The aim of the study was to explore safety and efficacy of non-descent vaginal hysterectomy in comparison to abdominal hysterectomy. Methods: This prospective case -control study was carried out in Faridpur Medical College Hospital, Faridpur, Bangladesh from May 2016 to April 2017. A total 150 cases with an indication of hysterectomy were selected of which 50 underwent non descent vaginal hysterectomy and rest 100 underwent total abdominal hysterectomy. Main outcome measures were: time taken to complete operation, estimated blood loss, need of blood transfusion, complications and length of hospital stay. Results: No significant association was found between age and parity. Commonest indication was dysfunctional uterine bleeding in non descent vaginal hysterectomy and fibroid was the most common indication for total abdominal hysterectomy. Patients of non descent vaginal hysterectomy group were operated with minimal blood loss, in lesser duration in comparison to patients operated by abdominal hysterectomy. Post-operative complications were more in abdominal hysterectomy like febrile morbidity (12%), wound infection (7%), UTI (6%), respiratory infection (8%) and paralytic ileus (6%) which was significantly higher than non descent vaginal hysterectomy. Faster recovery was observed in group of non descent vaginal hysterectomy. Conclusions: Non descent 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. So, non descent vaginal hysterectomy should be the choice of operation in selected cases.
Authors and Affiliations
Rosy N, Roy BN, Naher L, Hayat S, Sultana N
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