Vaginal versus abdominal hysterectomy in patients with a history of pelvic surgery

Abstract

Objective The aim of this study was to assess the efficacy and safety of vaginal hysterectomy compared with abdominal hysterectomy in women who had undergone a previous pelvic surgery. Patients and methods Fifty-four patients undergoing hysterectomy for benign conditions were randomized to either the vaginal or the abdominal group. Each group of patients had in common the fact that they had undergone previous pelvic surgery. Results Participants in the vaginal hysterectomy group had a shorter operating time (73.7 vs. 107.8 min, P<0.001), less blood loss (563 vs. 1219 ml, P<0.001), smaller decrease in haemoglobin level (0.86 vs. 1.8 g, P<0.001), earlier discharge from hospital, lower hospital cost, quicker return to normal activities and improved quality of life. Complication rates were not statistically different between the two groups. Conclusion Vaginal hysterectomy appears to be the preferred hysterectomy technique for women with previous pelvic surgery and every gynaecological surgeon should be familiar with this procedure.