Outcome assessment of total abdominal hysterectomy vs ascending vaginal hysterectomy

Abstract

Introduction Hysterectomy is a reasonably safe, common and routine surgical procedure which rarely leads to perioperative death. Minor complications including postoperative infections, fever, wound hematomas or wound separation occur in approximately 25% of patients. Objective A comparative assessment of the post-operative outcomes of Sri Lankan patients subjected to Total Abdominal Hysterectomy and Ascending Vaginal Hysterectomy for benign uterine diseases. Methods A randomized controlled trial was conducted on 60 patients who underwent hysterectomy from July 2013 to June 2014, in a tertiary care hospital. Women those who were waiting for hysterectomy for benign uterine diseases within age 35-55yrs were included for the study.30 patients were underwent abdominal hysterectomy and 30 patients were underwent vaginal hysterectomy. Five main variables were measured such as operative time in minutes, blood loss, post operative pain, pyrexia, hospital stay in days. Data entered and analyzed by SPSS 25.0. Result Age of participants was between 37 years of age to 51 years of age. Mean age was 44.87 years among Vaginal Hysterectomy group (SD 3.4 years) and 44.71 among Abdominal Hysterectomy group (SD 3.756 years). The average time duration for two procedures (t=10.4: p<0.05), average post operative hospital stay(t-10.1 ; df-58 ; p<0.05), Onset of post operative pain (X2 - 31.0:df – 2:p<0.05) and average blood losses between two groups(t-14.97;df-58;p<.05) were significantly different. Onset of fever was not significantly different in two groups (X2-0.48:df-1:p=.731). Conclusion When comparing abdominal hysterectomy and vaginal hysterectomy the time taken for abdominal hysterectomy and post operative stay at hospital following abdominal hysterectomy is higher than those of vaginal hysterectomy. Abdominal hysterectomy was associated with a significantly higher post operative pain. Onset of fever following surgery does not depend on the type of surgery.