Comparison of Vaginal and Abdominal Hysterectomy for Nonprolapsed Uterus-เปรียบเทียบการผ่าตัดมดลูกทางช่องคลอดและทางหน้าท้องในผู้ป่วยไม่มีภาวะมดลูกหย่อน

Abstract

           A retrospective comparative study was carried out on 1,030 women with nonprolapsed uterus with indication of hysterectomy in order to compare the effectiveness and safety of vaginal and abdominal hysterectomy in Nakhornping hospital during January 2004 - January 2006.  The two routes of surgery were compared by employing independent t-test at 0.05 level of significance in term of operative time, estimated blood loss or blood transfusion need, intraoperative and post operative complications and length of hospital stay.  Vaginal hysterectomy in nonprolapsed uterus was successfully performed in 236 women  (98.7%).  In 3 cases, vaginal hysterectomy failed due to slipped uterine vessels and was converted to explore laparotomy to stop intraperitoneum bleeding.  There were statistically significant differences in the mean operative time (p< 0.001), mean estimated blood loss (p<0.001) and mean hospital stay (p< 0.001) favoring vaginal hysterectomy.  It was concluded that vaginal hysterectomy is an effective and safe procedure, even for nonprolapsed uterus.  This route of hysterectomy is associated with less complications, operative time, blood loss and shorter length of hospital stay relative to abdominal hysterectomy.  Satisfactory results can always be expected once technical skills in vaginal surgery are fully improved

Key words:      vaginal hysterectomy, nonprolapsed uterus, abdominal hysterectomy, mean blood loss, operative time