Comparative Study Of Abdominal Versus Vaginal Hysterectomy In Non- Descent Cases

Hysterectomy, abdominal or vaginal, total or subtotal laparoscopic assisted vaginal hysterectomy is by far the most frequently performed elective major operation in Gynaecology. It is said that the two are not competitive procedures but each has its own place in the operative armamentarium of the gynaecologist. This study was done with the Objective to study the comparative risks of complications of abdominal and vaginal hysterectomies during intra-operative and post-operative period thereby improve the proportion of hysterectomies done vaginally. Method: A total of 50 patients in the study were divided into two groups. 25 cases in each group each designated as group-A and group-B underwent abdominal hysterectomy and vaginal hysterectomy respectively for non-prolapsed cases with good uterine mobility and uterine size less than16 week. Results: Intra-operative blood loss, mean operating time was more in group A than in group B (500±250,316±238) and (101±27.1 min, 65±26.2) respectively. Only one case of bladder injury was observed in group A, (which was a case of previous caesarean section) and none in vaginal route. Only one patient underwent re-laparotomy for internal bleeding via abdominal route. Postoperative fever (28% & 16%),UTI(20% & 15%)and abdominal wound infection(8%,0%) was more common in Group A as compared to Group B. Vaginal cellulitis (44% & 24%) and vault granuloma (20% & 0%) was found frequently in vaginal than in abdominal route. Conclusion: From the study results it can be concluded that patients requiring hysterectomy for benign non prolapse cases be offered the option of vaginal route which is less invasive, minimal or no complications, more economical and effective. In our centre, it is likely to replace abdominal hysterectomy as the operation of choice.