Pelvic abnormalities in hysterectomized patients-role of early postoperative ultrasonographic evaluation

OBJECTIVE: To assess the incidence of post-hysterectomy pelvic fluid collection in the early postoperative period and to study its natural history. STUDY DESIGN: Cross-sectional, prospective, observational study. PATIENTS AND METHODS: The study sample comprised 36 consecutive patients undergoing hysterectomy for benign conditions in our department. All patients underwent two pelvic ultrasonographic examinations, the first on the third postoperative day and the second one year later. All postoperative complications were thoroughly evaluated. RESULTS: Thirty-two patients completed the study evaluations. Abnormal ultrasonographic findings were detected in 4 of them on the early postoperative scan. Three (9.4% of the sample) had pelvic fluid collections which persisted on the follow-up scan. The fourth patient had a simple ovarian cyst 4 cm in diameter which disappeared on follow-up. None of the patients with pelvic fluid collections had a febrile morbidity during the postoperative course. CONCLUSIONS: Transvaginal ultrasonography can detect asymptomatic early postoperative pelvic fluid collections and enables conservative management, thereby reducing patients stress, medical costs, and the need for unnecessary interventions.