Shahida Akhtar.
Short and long term complications of Abdominal and Vaginal Hysterectomy for benign disease.
Pak Armed Forces Med J Jan ;54(1):71-5.

The present study was conducted to ascribe to the indications of short, intermediate and long term complications for total abdominal versus vaginal hysterectomy in women with benign pelvic disease. This study was carried out at Gynecology Department, CMH Peshawar. Chart review was conducted from 1993 to 1997, for all patients who had hysterectomy for benign disease. We compared indications for short, intermediate and long term complications of total abdominal versus vaginal hysterectomy. A total of 108 patients who had hysterectomy were available for analysis. Group I consisted of patients who had total abdominal hysterectomy (n=82), group 2 consisted of patients who had vaginal hysterectomy (n=26). The principal indication for the vaginal hysterectomy was uterine prolapse 18%, which occurred in women >45 years old. While, the most common indications for the total abdominal hysterectomy were menstrual disorders and uterine fibroids 56%, which occurred in women >45 years old. The overall complication rates were 51.2% and 23.1% , in women who underwent total abdominal hysterectomy and vaginal hysterectomy p=0.01. odds ratio=3.5) Twelve patients (14.6%) required 2nd intervention or rehospitalization, or both, in total abdominal hysterectomy group. While none were required in the hysterectomy group. Febrile morbidity formed the major category of the postoperative complications in our study, total incidence was 27.8% (30/108). No statistically significant differences were noted between the total abdominal hysterectomy (30.1%(25/ 82) and the vaginal hysterectomy group {19.2% (5/26), (p=0.3)}, nor for women who received antibiotic prophylaxis {25.5% (14/55)} and women who did not {28.3% (15/53), (p=0.7)}. Vaginal hysterectomy is associated with less intraoperative, intermediate and late complication rates than total abdominal hysterectomy. No significant differences in postoperative febrile morbidity, but significantly shorter hospital stay was found among women who under went vaginal hysterectomy.

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