The New Indian Journal of OBGYN. 12(1):103-110

Study of factors determining the route of hysterectomy and their correlation with decision making factors

Akriti Saxena, Alka S Gupta

ABSTRACT

Objectives: 1) To outline the factors for the route of the hysterectomy; 2) To identify factors which will allow the gynecologists to perform vaginal hysterectomy? Methods: The study was conducted in the Department of Obstetrics and Gynecology after approval from the institutional ethics committee. A total of 100 patients requiring hysterectomy were recruited for the study based on inclusion and exclusion criteria. They were divided into two groups, one which would undergo vaginal hysterectomy and one which would undergo abdominal hysterectomies. Their preoperative, intraoperative findings and postoperative parameters were then compared. Results: Sixty-six out of a total of 100 patients underwent vaginal hysterectomy. Mean age of the cohort was 46.77 years. Out of all the decision making factors, indications for the surgery (p=0.001), past history of abdominal surgery including caesarean section (p=0.0425), body mass index (p=0.0001), per abdomen findings such as palpable uterus or large ovarian masses (p=0.0001), descent of the uterus (p=0.0001) were amongst the significant factors in determining the route of hysterectomy. Conclusion: Performing surgeries vaginally is the hallmark of a gynecologist. Also, there are many advantages, proven time and again that vaginal hysterectomy has over abdominal hysterectomy. Unless contraindicated vaginal hysterectomy should be the first choice for route of hysterectomy. The most important step toward achieving this goal is a thorough clinical examination aided by ultrasonography or laparoscopy whenever it seems necessary to do so.