A comparison of abdominal and vaginal hysterectomy for the large uterus.
OBJECTIVE
To compare the perioperative outcomes of women with an enlarged uterus (>or=250 g) who had abdominal and vaginal hysterectomies.


METHODS
Retrospective study of the perioperative outcomes of 288 consecutive women with an enlarged uterus, of whom 200 underwent an abdominal hysterectomy and 88 a vaginal hysterectomy, all for benign gynecological conditions.


RESULTS
Among the perioperative complications, only the risk of ileus was significantly higher in the group that underwent abdominal hysterectomy. Although the need for blood transfusions was similar between the groups, mean perioperative hemoglobin change was significantly lower for women who had the abdominal approach. Vaginal hysterectomy shortened the length of hospitalization significantly but did not affect the operative time. All of these differences remained significant after adjusting for uterine weight (P<0.05). Baseline characteristics were similar between the groups, except for uterine weight.


CONCLUSIONS
For women with a uterus weighing 250 g or more, vaginal hysterectomy shortens the hospital stay without significantly increasing perioperative morbidity when compared with the abdominal route.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA 19140, USA. oz.harmanli@temple.edu
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Harmanli
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Gentzler
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Byun
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Dandolu
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Grody
D000328:Adult; D000075202:Contraindications; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007889:Leiomyoma / Q000601:surgery; D007902:Length of Stay; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000033:anatomy & histology*