Comparative study between vaginal and abdominal hysterectomy in non-descent cases

Abstract

Background: Hysterectomy is the major gynaecological surgery performed by gynaecologist all over the world. Various approaches have been tried by gynaecologist all over the world including abdominal, vaginal, laparoscopic, notes and robotic hysterectomy. Vaginal approach greatly reduces complications, decreases hospital stay, lowers hospital charges, post-operative discomfort and cosmetically better compared to abdominal and laparoscopic approaches. Vaginal hysterectomy in large sized uterus can be facilitated by bisection, myomectomy, debulking, coring and clamp less approach. The aim and objective of the study was to compare outcome of NDVH with outcome of TAH in terms of post-operative morbidity and duration of hospital stay. Methods: A total of 100 cases were selected with enlarged uterus of which 50 underwent NDVH and rest 50 underwent TAH. All patients were evaluated for operative time, intra-operative and post-operative complications and duration of hospital stay. Data were recorded and processed and standard statistical software were used. Results: Patients undergoing NDVH had an average operating time of 48.68 mins whereas for those undergoing TAH was 92.52 mins (‘p’- value <0.001). Intra-operative complications were noted in 2% of patients undergoing NDVH whereas in 20% of patients undergoing TAH (‘p’- value 0.016). Post-operative complications were noted in 34% of patients undergoing NDVH v/s 70% in TAH (‘p’- value <0.001). Patients undergoing NDVH had a mean hospital stay of 5.96 days whereas 9.10 days in those undergoing TAH (‘p’- value <0.001). Conclusions: NDVH is associated with decreased operative time, post-operative morbidity, early ambulation and early discharge from hospital compared to TAH.