Rumina Tabassum, Fariha Hasnny, Saleem Sabbar, Farah Hasnain, Fahad Hanif, Raheela Hanif.
Morbidity and postoperative recovery of hysterectomy cases.
J Surg Pak Jan ;15(2):73-7.

Objective To compare morbidity and post-operative recovery in cases of abdominal and vaginal hysterectomies. Study design Comparative study. Place & Duration of study Gynecological and Obstetrics Unit II of Civil Hospital Karachi associated with Dow University of Health Sciences during the year 2008. Methodology All patients who underwent hysterectomies during the study period for gynecological indications were included. Data from these cases were extracted on a specially designed proforma which included fields for patient’s age, uterine size, indication and route for hysterectomy, factors for pelvic adhesions, duration of surgery, intra operative blood transfusion, intraoperative and postoperative complications, pain, effective ambulation and discharge from hospital. Results There were a total of 107 cases in whom hysterectomy was performed. Out of this thirty three (29.46%) were vaginal hysterectomy (VH) cases and seventy four (69.64%) abdominal hysterectomy (AH) patients. Mean age was higher in cases of VH. Sizes of the uteri in cases of AH were bulky to greater than 14 weeks size while in VH were mostly atrophic (n 25). Main indications for AH were dysfunctional uterine bleeding (DUB) and fibroids however in VH all patients had uterovaginal prolapse with concomitant DUB in 12.13% of cases. Mean operative time was 117.45 minutes in VH as compared to AH where it was 102.84 minutes. Intraoperative hemorrhage and blood transfusions were more in VH (n 10 - 30.30%). In AH group 8(24.24%) patients received blood transfusions. Infections were seen more frequently in AH (n 25 - 36.13%) while urinary retention was noted in cases of VH only (n 3- 9.09%). Early effective ambulation, less pain and early discharge from the hospital were noted in VH group. Conclusions Abdominal hysterectomy was performed more often. Operative time and blood transfusions were more in VH. However better postoperative outcome and early discharge was noted in the VH when compared to AH.

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