Vaginal Hysterectomy versus Abdominal Hysterectomy for Enlarged Uterus: A Comparative Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 11
Abstract
Abstract: Hysterectomy is the commonest gynecologic operation performed. There are many approaches to hysterectomy for benign disease. To compare operative time, blood loss, requirements of volume reduction techniques in hysterectomy cases by abdominal and vaginal route A prosepctive study was carried out in the Department of Obstetrics and Gynecology, at tertiary health care hospital in Central India. Patients who has given written informed consent and fulfilled the inclusion and exclusion criteria were randomly divided into two groups. One group underwent abdominal hysterectomy and other group underwent vaginal hysterctomy. Operative time, blood loss, requirements of volume reduction techniques were compared among to groups. For descriptive statistics mean, standard deviation was used. Chi sqaure test was used as the test of significance. Total 50 pateints were selected for the study. 25 patients were randomly divided into two groups. One group underwent abdominal hysterectomy and other group underwent vaginal hysterctomy. Mean age of cases in abdominal was (47.68±9.28) years and (47.28±9.18) years in vaginal group. Mean parity in abdominal group was 2.76±1.33 and 2.56±1.22 in vaginal group. Most common indication of surgery was fibroid uterus (64%) in each group. The number of cases with size of uterus between 6 to 12 weeks in abdominal group were 18 (72%) and 20 (80%) in vaginal group. The number of cases with size of uterus more than 12 weeks in abdominal were 7(28%) and 5(20%) in vaginal group. Uterine weight wise distribution in abdominal and vaginal group was equal (P=0.6916, NS). Mean operative time required for hysterectomy in abdominal group (51± 5.95 minutes) was less as compared to vaginal (65.4± 8.28 minutes). This difference in mean operative time was statistically highly significant (p=0.0001).The mean blood loss in abdominal group was 326.2±35.30 ml and 301.8±39.16ml in vaginal group. So the mean blood loss is more in abdominal group than the vaginal group. This difference in mean blood loss was highly significant. (p=0.0097). In vaginal group bisection was done in 12 cases and morcellation with bisection and myomectomy was done in 8 cases. Coring with bisection and myomectomy was done in one case. No volume reduction techniques were required in cases of abdominal. Mean blood in abdominal group was more than vaginal group. Mean operative time in vaginal group was more than abdominal group. Moderate enlargement of uterus should not be looked upon as contraindication to vaginal hysterectomy and can be used with With proper case selection and use of bulk reducing techniques.
Authors and Affiliations
Dr. Rashmi M. Bhamare, Dr. Kashinath R. Koshti, Dr. Rajesh Gajbhiye
Keywords
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