Various effects of abdominal and vaginal hysterectomy in benign diseases.

ABSTRACT

The relative advantages and disadvantages of the transabdominal versus the transvaginal approach to hysterectomy were evaluated and the two procedures were compared for differences in hospitalization, patient age, bowel activity and operating time on the basis of a material of 94 hysterectomized patients. Intestinal complications such as subileus were noted only in subjects who were treated by abdominal hysterectomy. This corresponded with the significant decrease in potassium in abdominally operated patients on the second post-surgical day. Transvaginal hysterectomy was found to be superior in terms of all of these parameters. Complications associated with the two procedures were also compared. Of eight potential complications, seven were found to be confined to laparotomy, while only one occurred after transvaginal hysterectomy which was, however, invariably combined with colporrhaphy. The conclusion from the above should, therefore, be not to select patients indiscriminately for either the transvaginal or the transabdominal approach, but rather to use both routes of access as best fits the circumstances.