The comparison of postoperative pain: total laparoscopic hysterectomy versus vaginal hysterectomy

Abstract

Objective The purpose of this study was to evaluate postoperative pain of total laparoscopic hysterectomy (TLH) compared with vaginal hysterectomy (VH). Methods From June 2010 to August 2010, 122 patients were enrolled, of whom 56 underwent TLH and 66 underwent VH for benign diseases at Kangnam Sacred Heart Hospital. Postoperative pain degree was compared in non-randomized, prospective method and preoperative, intraoperative, postoperative characteristics were considered. Postoperative pain was measured using the visual analog scale (VAS) score at 1-hour, 1-day, 3-day postoperative periods and the additional consumption of analgesic units (vials and tablets) required by patients for pain relief at all hospital stay. Results For the fi rst 3 postoperative days, the median total consumption of analgesics was considerably lower in the TLH group than in the VH group (pethidine, P <0.05; non-steroidal anti-infl ammatory drug [Ketorolac Tromethamine], P <0.05). The VAS score also was higher for the VH group than in the TLH group (VAS 1-hour, P <0.05; VAS 1-day, P <0.05; VAS 3-day, P <0.05). No signifi cant difference was found between groups in respect to preoperative, intraoperative and postoperative characteristics except operation time, prior intra-abdominal surgery and pelvic adhesion. Conclusion In this study, since TLH is a less painful procedure in comparison to VH, TLH may be a good alternative to VH for the benign gynecologic diseases with expert surgeons. Keywords: Postoperative pain; Total laparoscopic hysterectomy; Vaginal hysterectomy Hysterectomy