Vaginal hysterectomy x abdominal hysterectomy

profile of surgical indications and complications

Abstract

Introduction: Hysterectomy is a procedure indicated to treat several pathologies that affect the female pelvic floor. This procedure can be performed in three different ways: the abdominal route, the vaginal route, and the vaginal route assisted by a laparoscopic. The choice of route will depend on the pathology to be treated and the general condition of the patient. Objectives: To evaluate the main surgical indications of hysterectomy and the choice of route (abdominal or vaginal). Tracing the profile of patients who underwent vaginal and abdominal hysterectomy; To compare the length of hospital stay between the vaginal and abdominal routes; To characterize the main complications in vaginal and abdominal hysterectomies; To evaluate the anatomopathological results for the vaginal and abdominal pathways. Methods: A retrospective cohort study was carried out, describing the result of the last year (January 2017 to December 2017) in the Hysterectomy performed by the Dona Iris Hospital and Maternity Surgery Team, in Goiânia (GO). Results: The profile of patients submitted to vaginal and abdominal hysterectomy was from women aged 40 to 49 years, where the main surgical indication was uterine myoma, the mean surgical time between the routes was between 01:01 and 2:00 h, mean hospital admission was significantly lower in the vaginal route. The length of hospital stay showed a significant difference between vaginal surgery (85% in one day, 68 patients) and abdominal surgery (49% in one day, 20 patients). And 5% of death to the abdominal route. Conclusion: The profile of patients submitted to vaginal and abdominal hysterectomy was of women aged 40 to 49 years, where the main surgical indication was uterine myoma, the mean surgical time between the routes was between 01:01 and 2:00 h, the mean hospital stay was significantly lower in the vaginal route. The length of hospital stay showed a significant difference between vaginal surgery (85% in one day, 68 patients) and abdominal surgery (49% in one day, 20 patients). The main complications were bladder injury in the vaginal route (7.5%) and ureter injury (5%) and urinary retention in the abdominal (7%). The most prevalent anatomopathological findings for the two routes were Leiomyomatosis, with 75% (HTV) and 66% (HT). Both pathways also presented 10% of malignant findings.