Introduction: Hysterectomy is the commonest major gynaecological surgery performed in women. Currently there are three main types of hysterectomy operations –abdominal hysterectomy (AH), vaginal hysterectomy (VH) and non descent vaginal hysterectomy (NDVH).

Objective: To compare abdominal route versus vaginal route of hysterectomy in terms of intraoperative and postoperative complications.

Material and Methods: A prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Shimla over a period of one year. Number of hysterectomies enrolled for the study were 479. Category I (TAH) accounted for maximum number of cases i.e. 281 (58.6%) followed by category II (VH) which accounted for 136 (28.3%) cases followed by 62 (12.9%) cases in category III (NDVH).

Observations: Mean durations of surgery in category I, II and III were 74.01 ± 22.2 minutes, 69.19 ± 19.01 minutes and 67.5 ± 23.12 minutes respectively and this was significantly more in  Category I (TAH) when compared to category II( VH) and category III (NDVH). Postoperative complications like fever, wound infection, UTI were also significantly more in category I (TAH) as compared to category II (VH) and III (NDVH) (p value <0.05).

Conclusion: Many advantages of NDVH over abdominal hysterectomy were no scar, no adhesions, less complications, shorter hospital stay and fast recovery. So vaginal route should be the preferred route for hysterectomy wherever possible.

Keywords: AH-Abdominal hysterectomy, NDVH-non descent vaginal hysterectomy, VH-vaginal hysterectomy

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Dr Rama Thakur

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