Analysis of Indications and Different Surgical Approaches for Gynecological Hysterectomies and their Consequences

Sidra Asif, Seemal Tajasar, Amna Bibi, Muhammad Ilyas Riaz, Khushboo Chandio, Omer Farooq
In: Pakistan Journal of Medical and Health Sciences · 2022 · vol. 16(12) , pp. 765–768 · doi:10.53350/pjmhs20221612765 · W4321214076
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This study of 631 women found that endometriosis and uterine bleeding were the primary indications for hysterectomy, with laparoscopic approaches demonstrating significantly lower complication rates than abdominal or vaginal methods.

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This study compared the effectiveness and complication rates of abdominal, vaginal, and laparoscopic hysterectomies in a cohort of 631 women undergoing benign procedures in Pakistan. The results indicated that endometriosis was the most frequent indication for surgery, followed by uterine bleeding and fibroids, with patients typically being multiparous and aged between 39 and 50 years. Laparoscopic hysterectomy demonstrated significantly fewer intraoperative and postoperative complications compared to abdominal and vaginal approaches, establishing it as the minimally invasive technique with the highest success rate. This paper is centrally about endometriosis — specifically listing it as the primary indication for hysterectomy among other gynecological conditions while comparing surgical outcomes.

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Abstract

Background: Hysterectomy is one of the most common gynecological surgeries regardless of the surgeon’s approach. Purpose: This study was conducted to compare three hysterectomy techniques, viz abdominal, vaginal and laparoscopic hysterectomy, in terms of their effectiveness and low post-op complications. Methods: The study's cohort included 631 women who underwent benign hysterectomies between 2018 and 2022 in tertiary care hospitals in three areas of Pakistan. The patients in Groups A, B, and C comprised 277, 43 and 311 patients, who were surgically operated by LHs, VHs, and AHs, respectively. Findings: Most of the patients with BH were of age 39-50 years and multiparous with an average weight of 71.4+15 Kg. The major (p<0.05) underlying medical conditions were endometriosis, followed by uterine bleeding, fibroids, pelvic prolapse, adenomyosis and gynecological cancer having an incidence of 44.05, 36.45, 11.88, 5.38, 1.26 and 0.95%, respectively. The AH and VH had the highest incidence of surgical and post-operative problems (p<0.05) compared to the LH, with percentages of 56.59, 55.81, and 20.21%, respectively. Among complications, most often observed were thrombosis, post-operative infections, and bleeding (p<0.05). Practical implications: It was recommended that the gynaecologist should pursue LH, which is less invasive and has a high success rate, for BH. Conclusion: It was thus concluded that the laparoscopic hysterectomy was minimally invasive and was associated with a low incidence of intraoperative and postoperative complications. Keywords: Endometriosis; Non-invasive hysterectomy; Laparoscopic hysterectomy; Intraoperative complications.
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Background

Hysterectomy is one of the most common gynecological surgeries regardless of the surgeon’s approach. Purpose: This study was conducted to compare three hysterectomy techniques, viz abdominal, vaginal and laparoscopic hysterectomy, in terms of their effectiveness and low post-op complications.

Methods

The study's cohort included 631 women who underwent benign hysterectomies between 2018 and 2022 in tertiary care hospitals in three areas of Pakistan. The patients in Groups A, B, and C comprised 277, 43 and 311 patients, who were surgically operated by LHs, VHs, and AHs, respectively. Findings: Most of the patients with BH were of age 39-50 years and multiparous with an average weight of 71.4+15 Kg. The major (p<0.05) underlying medical conditions were endometriosis, followed by uterine bleeding, fibroids, pelvic prolapse, adenomyosis and gynecological cancer having an incidence of 44.05, 36.45, 11.88, 5.38, 1.26 and 0.95%, respectively. The AH and VH had the highest incidence of surgical and post-operative problems (p<0.05) compared to the LH, with percentages of 56.59, 55.81, and 20.21%, respectively. Among complications, most often observed were thrombosis, post-operative infections, and bleeding (p<0.05). Practical implications: It was recommended that the gynaecologist should pursue LH, which is less invasive and has a high success rate, for BH.

Conclusion

It was thus concluded that the laparoscopic hysterectomy was minimally invasive and was associated with a low incidence of intraoperative and postoperative complications.

Keywords

Endometriosis; Non-invasive hysterectomy; Laparoscopic hysterectomy; Intraoperative complications.

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endometriosisadenomyosis

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