Common Gynecological Surgery Research Articles

Histerectomía total vía abdominal: revisión de la literatura

Hysterectomy is the most common gynecological surgery in non-pregnant women. There are different surgical approaches for total hysterectomy, abdominal, vaginal, laparoscopic and robotic routes. The choice is determined by different factors such as uterine size,
 malformations, surgical risks, skill of the surgeon, expected postoperative quality of life, and monetary costs. The surgical technique is well described in the literature, however, there are certain anatomical and functional considerations that must be known before performing the hysterectomy to avoid complications. The most frequent complications are hemorrhage, infections, thromboembolism, urinary and gastrointestinal tract injuries. Majority can be avoided with an adequate procedure and management of pre-existing comorbidities.

Comparison between Laparoscopic, Abdominal, and Vaginal Hysterectomy in the Treatment of Gynecological Disease: A Retrospective Review Over Five Years

Background: Hysterectomy is one of the most common gynecological surgery worldwide. It is usually performed through the abdominal, vaginal or laparoscopic routes. The objective of this study was to evaluate the role of laparoscopic, vaginal and abdominal hysterectomy in the management of gynecological conditions in terms of operative outcomes, such as operating time and estimated blood loss, as well as complication rates. Methods: This was a retrospective cohort study carried out over a 5-year period (2016-2020) at Zahraa University Hospital. Patients who underwent abdominal vaginal, and laparoscopic hysterectomies performed for the treatment of multiple gynecological disease during that period were included. Results: A total of 222 patients were included in the study, 168 (75.7%) patients in the abdominal hysterectomy group, 7 (3.2%) in the vaginal group, and 47 (21.1%) in the laparoscopic group. The mean age was 49.83±9.28 years for the abdominal, 67.14±13.79 for the vaginal, and 47.26±6.77 years for the hysterectomy groups. The most common indication for hysterectomy was the presence of uterine fibroids in the abdominal and laparoscopic groups (47.6% vs. 31.9% respectively) whereas it was pelvic organ prolapse for all patients in the vaginal group. Around 18% in the abdominal group had abnormal uterine bleeding compared to 6.4% in the laparoscopic group. Endometrial hyperplasia was the indication for 9.5% of the patients in the abdominal group while it was 25.5% for the laparoscopic group. Surgery duration was significantly the shortest for abdominal hysterectomy (2.30±0.92 hours), followed by vaginal hysterectomy (2.86±0.24 hours), and the longest was for laparoscopic hysterectomy (4.14±0.90 hours) (p-value<0.0001). The size of the uterus was slightly larger in the abdominal hysterectomy group though the difference was not significantly different. There were no significant differences in pre- and post-operative hemoglobin, or in estimated blood loss among the groups. There were no complications in the vaginal group. The rate of complications was similar between the abdominal and laparoscopic groups (15.5% vs. 17.0% respectively). The most common type of intraoperative complication in the abdominal group was bleeding requiring transfusion (34.6%), followed by bladder injury (11.5%). Only one patient in the laparoscopic group had intra-operative complication (bladder injury). As for post-operative complications, urinary retention and pyrexia related to wound infection were the most common in the abdominal group (7.7%). Seven patients in the laparoscopic group had post-operative complications. Most patients were readmitted to the hospital (98.8% vs. 100.0% vs. 95.7% in the abdominal vs. vaginal vs. laparoscopic groups respectively). Conclusion: Laparoscopic hysterectomy is associated with less morbidity, and shorter hospital stay than the other techniques, but it has longer operating time and requires laparoscopic instrument and surgical skills. Advances in equipment, surgical techniques, and training make laparoscopic hysterectomy an efficient and well-tolerated technique.

AN OBSERVATIONAL STUDY SHOWING MERITS AND DEMERITS OF HYSTERECTOMIES THROUGH VAGINALAND ABDOMINAL ROUTES FOR GYNAECOLOGICAL CONDITION WITHOUT UTERINE DESCENT

BACKGROUND: Hysterectomy is the most common gynaecological Surgery performed on women next to caesarean section. Hysterectomy remains one of the most frequently performed gynaecological operations. The introduction of antisepsis, anaesthesia, antibiotics and blood transfusion has made hysterectomy a safe procedure. METHODS: This study was an observational and cross sectional study conducted in the Department of Obstetrics & Gynaecology of Burdwan Medical College & Hospital, Burdwan, West Bengal a tertiary teaching institute, from April 2019 – March 2020. 100 patients were included in the study after informed consent from the patient about being a part of this study. Of them 50 patients underwent vaginal and rest 50 patients underwent abdominal hysterectomy. Template was generated in MS excel sheet and analysis was done on SPSS software. RESULTS: Majority 50 (50%) patients belonged to age group 41-45 years. In group A(TAH) out of 50 patients 40 had no injury, 5 had bladder injury, 5 had bowel injury. In group B (VH) out 50 patients undergoing hysterectomy 48 patients had no injury 2 had bladder injury and none had bowel injury. In group A2 people had wound infection post operatively. In group B none had wound infection post operatively. CONCLUSIONS: It can be concluded that NDVH is safe, more comfortable to the patient, is associated with lesser blood loss, lesser intraoperative injury, lesser duration of surgery, lesser post operative morbidity and should be conducted wherever feasible.

Outcome of Non Descent Vaginal Hysterectomy in Benign Gynecological Condition

Background: The most common gynaecological surgery is hysterectomy which is indicated mostly in DUB, fibroids, adenomyosis to malignancies. The various procedures range from laparoscopic to vaginal hysterectomies in non- descent cases. Vaginal Hysterectomy appears to be, relatively advantageous or superior procedure in terms of patient safety, cost-effectiveness, faster recovery (short hospital stay), and dreaded complications. It is the only surgery which has a very good cosmetic benefit that is without any visible scar.Aim: To study the outcomes of Non-descent vaginal hysterectomy in benign gynaecological conditions.Objectives: 1. To assess the outcome of Non- descent vaginal hysterectomy for benign Gynaecological conditions in terms of intra operative characteristics.2. To assess the postoperative outcome in Non-descent vaginal Hysterectomy. Materials: This prospective observational study was conducted between November 2018 to October 2020. The study was done among 100 women who fulfilled the inclusion criteria. Details regarding indication, size of the uterus, operation time, mean blood loss ,hospital stay and intraop and post op complications were noted.Results: The mean age was 46.05±5.413. The mean operating time was 58.46±17.75 minutes, the mean blood loss was 91.79±27.18 ml and the mean hospital stay was 4.24 ± 0.63 days. Majority (57) of the patients indication of surgery was DUB. 47% of the patients had normal uterine size, 23% and 27% had less than 8 weeks and between 8-12 weeks uterine size respectively. Only 3% subjects had uterus size between 12-36 weeks.Majority subjects had no postoperative complications, whereas other complications like fever , UTI , vaginal bleeding and need for blood transfusion were foundin 06,04,03 ,04 subjects respectively, and none of them had any intra op injury

The incidence of unexpected gynaecological malignancies in hysterectomies carried out for benign indications

The aim of the present study was to determine the incidence of unexpected gynaecological malignancies in patients undergoing hysterectomy for benign indications and to evaluate their clinical characteristics. Data from 6448 cases who had undergone hysterectomy for benign indications between the dates of 01.01.2008–01.01.2018 were recorded retrospectively from the database of the institution. The mean age of the cases with malignancy was 59.2 ± 9.66 (45–80) and 76,31% were (29/38) postmenopausal. The mean gravidity was 3.94 ± 1.73 and parity was 3.31 ± 1.45. Their mean BMI was 29.6 ± 4.26 kg/m2 (22.4–41.9 kg/m2 range). These patients were followed for a mean duration of 60.68 ± 37.66 months and during this period death associated with malignancy occurred in 4/38 (%10.52) cases, all of whom had leiomyosarcoma. The benign indications of procedure were as follows: myoma uteri (2675, 41.48%), abnormal uterine bleeding (1508, 23.38%), uterine prolapsus (793, 12.29%), ovarian cyst (619, 9.59%), endometriosis (303, 4.69%), endometrial polyp (264, 4.09%), pelvic pain (238, 3.69%) and other benign causes (48, 0.74%). Unexpected gynaecological malignancy was found in 20 cases (0.31%) with endometrial cancer, in eight cases (0.12%) with uterine sarcoma, in seven cases (0.10%) with ovarian cancer, in one case (0.01%) with tubal cancer and in two (0.03%) with cervical cancer. Gynaecological malignancy was found in 38 of 6648 cases who underwent hysterectomy for benign indications, yielding an incidence rate of 0.58%. IMPACT STATEMENT What is already known on this subject? Hysterectomy is the most common gynaecological surgery in the world and although most are performed for benign indications, unexpected gynaecological malignancy is possible in the final pathology results. Although there are available publications investigating unexpected gynaecological malignancy incidences after hysterectomies for benign reasons, the incidence is still not clear. We aimed to contribute to the existing literature with this study, which includes a large number of cases. What do the results of this study add? Our study adds new findings to the body of the knowledge on the incidence of unexpected gynaecological malignancies in hysterectomies for benign indications. Gynaecological malignancy was found in 38 of 6648 cases who underwent hysterectomy for benign indications, yielding an incidence rate of 0.58%. What are the implications of these findings for clinical practice and/or further research? There is an unexpected possibility of gynaecological malignancy even in cases where it is expected to be benign with current diagnostic methods. In cases that are expected to be benign, detailed preoperative evaluation should be performed in all patients to prevent unexpected gynaecological malignancies. More sensitive screening methods should be developed especially in the preoperative differential diagnosis of leiomyoma and leiomyosarcoma.

5,926 hysterectomies: complications described by Clavien–Dindo classification

Hysterectomy is the most common major gynaecological surgery. Due to its high volume, the analysis of its results is relevant. The objective of this study was to describe intraoperative complications and reoperations, for both benign and malignant causes, using the Clavien–Dindo classification (approved by local ethics committee, number 100220). Between 2000 and 2019, 5926 elective hysterectomies were performed, of which 90.2% were for benign aetiology and 9.8% for malignant causes. The abdominal route was 52.7%, vaginal 40.1% and laparoscopic 7.2%. Intraoperative complications and reoperations (grade III Clavien–Dindo) were 4% and 2.1%, respectively. Oncological surgery had significantly more intraoperative complications (10% vs. 3.4%) and reoperations (3.6% vs. 1.9%) than benign procedures. Noteworthy, intraoperative complications required a new operation in only 3.4% for malignant and 2.8% for benign surgery. Our data showed the relevance of detecting and rectifying intraoperative complications during surgery, which consequently leads to a lower reoperation rate, minimising postoperative morbidity and mortality for patients. Impact Statement What is already known on this subject ? The surgical complications of hysterectomy, both intraoperative and postoperative, are extensively described. However, this information is not well systematised, in which elective and emergency surgery are mixed. In addition to the above, there are few documents comparing the results of hysterectomies due to benign versus malignant causes. What the results of this study add? Using the Clavien–Dindo classification, this study adds an organised description of intraoperative complications and reoperations of hysterectomy in the context of elective surgery. In addition, it provides information on the comparison between surgery for benign versus malignant causes, as well as information on intraoperative complications requiring a new operation. What the implications are of these findings for clinical practice and/or further research? These findings provide clear and orderly data about the risks of elective hysterectomy and showed the relevance of detecting and rectifying intraoperative complications during the procedure. This is useful for specialists to preoperatively identify the risks for each hysterectomy group and provide their patients with more detailed information during informed consent.

A clinicopathological study of endometrium in hysterectomy specimens with fibroids

Introduction: Hysterectomy is the most common gynaecological surgery performed in the peri menopausal and post menopausal women all over the world. The commonest pathologies in such hysterectomies are uterine fibroids. Many times hysterectomies are also performed for dysfunctional uterine bleeding, in which leiomyomas are commonly noted. When such hysterectomy specimen are grossed and sections studied, co-existing endometrial lesions like hyperplasias, metaplasias, malignancies are usually missed due to the significant presence of leiomyoma. Aim of the Study: The present study intends to unravel all such endometrial pathologies, which would have been missed when there is a co-existing uterine leiomyoma and to categorize these lesions into different groups. Materials and Methods: The study material was obtained from patients who underwent hysterectomy for leiomyoma from December 2011 to August 2013. 200 hysterectomy specimens were included in the study. Tissue bits from representative areas were taken, microscopic sections obtained and histological features studied. Results: Leiomyomas occurred mostly in women aged between 41-50 years and in multiparous women. Menorrhagia was the commonest presentation. Endometrial pattern commonly seen was proliferative phase and hyperplasia. Other patterns like endometrial adenocarcinoma, endometrial polyps and pill endometrium were also encountered. Conclusion: Leiomyomas are estrogen dependent tumours, wherein the endometrium manifests mostly as proliferative phase or hyperplasia suggesting estrogenic prevalence. Findings such as endometrial hyperplasia, polyposis along with distorted, dilated or elongated glands in endometrial curetting could suggest a possibility of uterine leiomyoma. Keywords: Leiomyoma, Hysterectomy, Endometrium, Hyperplasia, Metaplasia, Carcinoma.

Prevalence of Hysterectomy among Gynecological Surgeries in a Tertiary Care Hospital.

Hysterectomy is the most common gynecological procedure. Over the last decade, the minimally invasive approach has been practiced more frequently. Fibroid uterus being the most common indication for hysterectomy justifies this minimal approach, however, whenever feasible, vaginal hysterectomy can be the preferred route. The objective of this study was to find out the prevalence and indication of hysterectomy among major gynecological surgeries in a tertiary care hospital. A descriptive cross-sectional study was done at a tertiary care hospital among 1912 patients who had major gynecological surgeries from January 2017 to December 2019. Ethical clearance was obtained from the institutional review committee (ref. no. ACD 935/076/077). Convenient sampling was used. Statistical analysis was done using Statistical Package for Social Sciences version 21.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. During the study period, there were 1,912 major gynecological surgeries and the prevalence of hysterectomy was 1,131 (59.15%) (56.94-61.35 at 95% Confidence Interval). Fibroid uterus was the most common clinical indication for hysterectomy which was done in 397 (35.10%) patients, followed by uterovaginal prolapse in 254 (22.46) patients, adnexal mass in 210 (18.56%), and abnormal uterine bleeding in 117 (10.34%) patients. Hysterectomy, being the most common gynecological surgery, selection of the most appropriate route is of paramount importance. As for any other surgery, it is not without complication and hysterectomy should always be justified. With the advancement in the conservative approaches, these organ-preserving options should be explored rigorously before opting for hysterectomy.

Postoperative Narcotic Use After Ambulatory Gynecologic Surgery

Objective: This article describes the average number of narcotics used after common ambulatory gynecologic surgeries and describes provider prescribing patterns. Materials and Methods: This was a p...

Sexuality in Women After Hysterectomy

Hysterectomy is the most common major gynecological surgeries, with up to 39,4% women will experience it during her lifetime. This procedure can be stressful for women as half of them will experience mild to severe physical and psychological complications. Uterus removal is often associated with de-feminization, castration, being disabled and loss of wholeness which may alter body image and self-esteem, ultimately lead to depression. Most women are anxious on how hysterectomy affect their sexuality, but only few feel comfortable discussing this essential matter to health professionals. The evaluation and management of sexual dysfunction had been the traditional province of psychiatrist. Psychiatrists should fulfill their competencies by updating knowledge on sexuality and sexual dysfunction, improving communication skill, being comfortable with own sexuality and discussing sexuality with other. Pharmacotherapy, relaxation techniques, behavior therapy, group therapy, analytical oriented sex therapy, dual-sex therapy and other techniques or exercises are some modalities option which may help women with sexual difficulties post-hysterectomy.

A rare case of prolapse of ovarian cyst through vaginal vault

Hysterectomy is the most common gynecological major surgery. It is performed for both benign and malignant conditions of the female genital tract. Common indications of hysterectomy include abnormal uterine bleeding (fibroids, adenomyosis), pelvic inflammatory disease. It can be performed via abdominal or vaginal routes depending on the pathology. In this era of minimally invasive surgery, laparoscopic hysterectomy is gaining popularity. Complications of this surgery depend on the etiology, route of hysterectomy and the technique used. Common complications of this procedure include infections, hemorrhage, thromboembolism, urinary tract, gastrointestinal injury. Vault prolapse can also occur years after performing a hysterectomy. Prolapse of fallopian tubes and omentum through the vault have been reported. However, prolapse of other abdominal and pelvic organs like bowel, ovary, and bladder through the vaginal vault is a rare entity. Prolapse of the ovarian cyst through vaginal vault has so far not been reported in the world literature. The present case report was of a very rare case of ovarian cyst prolapse through the vaginal vault in a 35-year-old woman; which was successfully treated by laparotomy and ovarian cystectomy. Her post-operative histopathology was suggestive of mucinous cystadenoma. Her post-operative period was uneventful, and she was discharged in a stable condition.

Surgical Approaches for Common Gynecologic and Obstetrics Surgeries.

Common obstetrics and gynecology operations have different approaches and techniques and variations in the procedure. We aimed to discuss different approaches and variations in the techniques of the procedures as cystectomy, myomectomy, laparoscopy entry technique, sacrospinous ligament fixation, uretherocele, and rupture uterus.

Postoperative Narcotic use After Ambulatory Gynecologic Surgery

Objective: This article describes the average number of narcotics used after common ambulatory gynecologic surgeries and describes provider prescribing patterns. Materials and Methods: This was a p...

Augmentation of Vaginal Cuff Closure During Laparoscopic Hysterectomy Using Viable Cryopreserved Umbilical Tissue

Abstract Background: Hysterectomy is one of the most common female gynecologic surgeries. However, this surgery poses a risk for postoperative vaginal vault granulation, bleeding, infection, and de...

Assessment of Women's Psychological Health with Hysterectomy at Maternity Hospitals in Baghdad City

Hysterectomy is one of the most common gynecological surgeries performed worldwide. However, women undergoing this surgery often experience negative emotional reactions. Controversy regarding psychological or psychiatric outcomes following hysterectomy still exists. The purpose of this study was to investigate the risk of postoperative psychiatric disorders in women with hysterectomy. This study was conducted to assess psychological Health of women with Hysterectomy at Maternity Hospitals in Baghdad City. This study was conducted at maternity hospitals in Baghdad city to assess the psychological health of women with hysterectomy. This study was started in January 2018 to January 2019, The data regarding was achieved from the patient's charts that recorded in the Statistical Department in the hospitals, the study consist of (100) women with hysterectomy which were selected according to inclusion criteria Women who had undergone hysterectomy, Postoperative duration for hysterectomies from 6weeks to 6 month, Women in reproductive age only. The data are analyzed through the use of descriptive statistical analysis and inferential statistical analysis procedures were employed for the data analysis. The findings of the study shows moderate levels of psychological health (50%), the highest percentage of women with hysterectomy were suffering from psychological problem.

Management and Outcome of Postoperative Complications among the Patients Undergoing Common Obstetric and Gynaecological Surgery outside the RMCH

Objective: To review the management and outcome of postoperative complications after common obstetric and gynecologic surgeries performed in outside nonacademic private hospitals (clinics) and peripheral public hospitals (districts hospitals) and later admitted in Department of Obstetrics and Gynecology of Rajshahi Medical College Hospital (RMCH). RMCH is a tertiary referral hospital where all complicated patients were referred for better management from surrounding hospital.Methodology: This Quasi-experimental study was carried out in the Department of Obstetrics and Gynecology at Rajshahi Medical College Hospital, Rajshahi, Bangladesh between July 1, 2015 and June 30, 2017. All patients admitted with post operative complications following common obstetric and gynecologic surgeries during this period were included. Patients admitted with post operative complications, where primary surgery was done in this hospital were excluded. The common obstetric and gynaecological surgeries were caesarean sections (LUCS), total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) performed outside Rajshahi Medical College Hospital.Result: During this period a total of 39,929 patients were admitted through emergency way in obstetrics and gynecology department of Rajshahi Medical College Hospital. Among them 675 patients were admitted with the complaints of post operative complications following common obstetric and gynecologic surgeries with rate being 1.7%. In 560(83%) cases surgery was done in clinics and 115(17%) cases surgery was done in district hospitals. Among the patients 580(85.9%) cases primary operation was done by non-gynaecologic surgeon and 95(14.1%) cases by gynaecologic surgeon. Caesarean section was the primary obstetric surgery in 405(60%) cases .Gynecologic surgeries included TAH in 185(27.4%) cases and VH in 85(12.6%) cases. We found 25(3.7%) patients died from these complications. Repeat surgery was done in 90(13.33%) cases. Genitourinary fistula repair was done in 41 cases (45.55%). Rests were improved by conservative management.Conclusion: Any surgical procedure carries risk of complications. Careful selection of patients with suitable indications for operations, expertise of the surgeon, good surgical technique, proper knowledge of pelvic anatomy and careful postoperative follow up can minimize recognized complications.TAJ 2017; 30(2): 7-12

Probability of hysterectomy in Germany

Introduction Hysterectomy is the most common gynecological surgery in many industrialized countries. In Germany, the hysterectomy rate is high in comparison to other European countries. The aim of this analysis was to determine the distribution of age at hysterectomy as well as the age-specific probability of undergoing a hysterectomy between the ages of 0–64 in the German female population. Methods Analyses were based on data from the MARZY study, a prospective, randomized, population-based cohort study investigating early detection of cervical cancer in western Germany. At baseline, 6429 women were invited to attend cervical cancer screening. The distribution of age at hysterectomy as well as indications for hysterectomy was reported. Based on survival analysis, which accounts for censoring at the age of interview, and the inverse probability weighting (IPW) method, the age-specific probability of undergoing a hysterectomy was estimated. The IPW method corrected for missing date of hysterecomy. Simulated calendar-period specific survival curves (1939–1979, 1980–1989, 1990–1999, 2000–2006) were computed to show how age and calendar year determine the probability of undergoing a hysterectomy. Results Data on hysterectomy were available for 4719 women. Of these, 961 women (20.4%) had undergone a hysterectomy. The main indication for hysterectomy was uterine fibroids (48%). A total of 850 women (88.4%) reported a date when their hysterectomy had been performed. The highest proportion of women was hysterectomized between the ages of 40–44 (24.6%). The IPW corrected probability of having a hysterectomy between the ages of 0–64 was 0.354. The age-specific probability of hysterectomy was highest in the 45–49-year age group (0.078). The age-specific probability of hysterectomy decreased between the years 1939 to 2006. Conclusion Data from the MARZY study allowed valuable conclusions to be drawn about the distribution of age at hysterectomy as well as the age-specific probability of undergoing a hysterectomy in Germany.

Pelvic organ prolapse surgery following hysterectomy with benign indication: a national cohort study in Taiwan.

Hysterectomy and pelvic organ prolapse (POP) surgeries are two of the most common gynecologic surgeries conducted for benign conditions. This nationwide retrospective cohort study explored the risk of subsequent POP surgery following hysterectomy without simultaneous POP surgery. This study identified 7298 patients who underwent hysterectomy between January 1, 2000, and December 31, 2012, from the Taiwan National Health Insurance (NHI) Research Database. A comparison cohort was constructed comprising 29,192 age-matched patients who had not undergone hysterectomy. All hysterectomy and control patients were followed until they required POP surgery, withdrew from the NHI system, died, or December 31, 2012. Patients were excluded if they underwent POP surgery before or at the time of hysterectomy. The adjusted hazard ratio (aHR) of subsequent POP surgery in subjects with hysterectomy was higher [2.60, 95% confidence interval (CI) 1.79-3.78] than that of controls during the follow-up period. Compared with patients who had not undergone hysterectomy, the highest risks of subsequent POP surgery was noted in those who had undergone vaginal hysterectomy (VH; HR 6.29, 95% CI 1.54-25.79) followed by those who underwent laparoscopy-assisted VH (LAVH; HR 3.77, 95% CI 2.43-5.85). Hysterectomy may increase the risk of subsequent POP surgery, and various hysterectomy techniques, particularly VH and LAVH, may increase the risk of subsequent POP surgery.

Optimal timing of post-operative haematocrit check in obstetric and gynaecological surgeries

Background: Haemorrhage is a feared albeit common complication of surgery in Obstetrics and Gynaecology. Measurement of haematocrit post operatively is believed to be part of good medical practice since it gives an inkling to intraoperative and immediate post-operative blood loss and the need for blood transfusion. The objective of the study is to determine if there was any difference between haematocrit values gotten on day 1 and 2 and also to determine the optimal time for the post-operative haematocrit check.Methods: One thousand patients who had surgery in the department of Obstetrics and Gynaecology of LAUTECH Teaching Hospital (LTH) and Bowen University Teaching Hospital (BUTH), Ogbomoso were recruited. Capillary blood samples were obtained at 24hours and 48 hours post operatively. The haematocrit was determined using a 24 place micro haematocrit centrifuge and the values checked using a haematocrit reader. Frequency tables and charts were made and results were tested for significance with level of significance (x) set at 0.05.Results: The mean age of the patients was 32.88±9.45, with a modal age group of 21-30years. The commonest obstetric surgery done was caesarean section (60.6%) while the commonest gynaecological surgery was myomectomy (13.8%). There is a significant difference between the haematocrit values gotten on day one and two (p= 0.000). There was significant difference between the haematocrit values on both days and the unit the patient was managed; the type of surgery done and the age group of the patient.Conclusion: The haematocrit on postoperative day 2 is more representative of the blood loss.Keywords: postoperative, haematocrit, obstetrics, gynaecology

Incidence and association factors for the development of chronic post-hysterectomy pain at 4- and 6-month follow-up: a prospective cohort study.

Chronic pain has major adverse effects on health-related quality of life and contributes to significant socioeconomic burden. Hysterectomy is a very common gynecological surgery, resulting in chronic post-hysterectomy pain (CPHP), an important pain syndrome. We conducted a prospective cohort study in 216 Asian women who underwent abdominal or laparoscopic hysterectomy for benign conditions. Demographic, psychological, and perioperative data were recorded. Postoperative 4- and 6-month phone surveys were conducted to assess the presence of CPHP and functional impairment. The incidence rates of CPHP at 4 and 6 months were 32% (56/175) and 15.7% (25/159), respectively. Women with CPHP at 4 and 6 months had pain that interfered with their activities of daily living. Independent association factors for CPHP at 4 months were higher mechanical temporal summation score, higher intraoperative morphine consumption, higher pain score in the recovery room, higher pain score during coughing and itching at 24 hours postoperatively, and preoperative pain in the lower abdominal region. Independent association factors for CPHP at 6 months were preoperative pain during sexual intercourse, higher mechanical temporal summation score, and higher morphine consumption during postoperative 24 and 48 hours. In a majority of cases, CPHP resolved with time, but may have significant impact on activities of daily living.