Morbidity Associated with Vaginal and Abdominal Hysterectomy in a Northern Nigerian Hospital
Keywords:Vaginal and abdominal hysterectomy, morbidity
Background: hysterectomy is one of the most common surgeries performed in gynaecological practice. It can be carried out either by vaginal or abdominal route. We compared the complications associated with the two types of surgeries.
Methods: A retrospective study involving all patients that had vaginal and total abdominal hysterectomy for benign conditions between January 2002 and December 2009 (8 years) at the Federal Medical Centre Birnin- Kebbi, Kebbi State, Nigeria
Results: During the period,493 major gynecological operations were performed in the health centre with vaginal and total abdominal hysterectomy constituting 48 (9.7%) and 69 (14.0%) of the surgeries respectively. The only indication for the former was uterine prolapse while the main indication for the latter was uterine fibroid (82.6%). Excessive primary haemorrhage was statistically significantly higher in vaginal hysterectomy compared with abdominal hysterectomy (45.8% versus 17.4%; p-value <0.05). Other complications did not yield any statistically significant difference : bladder injury (8.3% versus 3.0%), bowel injury (0% versus 3%), ureteric injury (0% versus 1.4%), wound infection (4.2% versus 8.7%) and maternal death (2.1% versus 3.0%). The average duration of hospital stay in vaginal hysterectomy was 4.2 ± 0.6 days compared to 7.8 ±1.2 days in the abdominal procedure (p<0.05).
Conclusion: Excessive primary haemorrhage was significantly commoner in vaginal hysterectomy compared to its abdominal counterpart, however, other complications were not. Furthermore, the former had the advantage of shorter duration of hospital stay compared to the latter.
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