scholarly journals Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome

2014 ◽  
Vol 13 (2) ◽  
pp. 36-41
Author(s):  
Rinku Das ◽  
Rummana Jafrin ◽  
Banita Biswas ◽  
Nazmun Nahar ◽  
Rajat Sanker Roy Biswas
Keyword(s):  
Blood Loss ◽  
Wound Infection ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Computer Based ◽  
The Common ◽  
Laparoscopic Assisted ◽  
Prolonged Hospital

Introduction: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Mode of treatment depends on age of the patients, number, size and site of the myoma and also fertility status of the patients. Materials & methods: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in BSMMU, Dhaka, Bangladesh, the study was carried out. 50 patients of diagnosed leiomyoma admitted in the BSMMU, Dhaka was selected for the study. Clinical profile, type of surgery and postoperative follow up findings were noted. Data was analyzed by computer based software SPSS – 18.Results: The common complaints among the 50 patients were progressive menorrhagia (70%), abdominal swelling (50%), infertility (24%), weight in pelvis (38%), weakness/dizziness or syncopal attack after menstrual period (26%) and recurrent miscarriages (12%). The average uterine size at presentation was 15±9.7 weeks. The majority (70%) of the women presented with multiple leiomyomata. The commonest anatomical position of the myomas were multiple positions and intramural(80%). Total abdominal hysterectomy with or without bilateral sulphingo ophorectomy according to age was the commonest surgical procedure performed in thirty two (64%) cases. Myomectomy was done in 12(24%) cases and laparoscopic assisted vaginal hysterectomy was done in also 6(12%) of patients.  Postoperative complications occurred in 24%(12) of the women. The most common complications were postoperative pyrexia 12%, blood loss  warranting transfusion 8%, wound infection 10% and prolonged hospital stay 6%.Conclusion: Uterine fibroid is common in our environment and most of the patients had regular menstrual cycle with progressive menorragia. Its removal is commonly associated with post-operative pyrexia, blood loss, and anemia and wound infection. Preoperative correction of anemia appropriate use of antibiotics and strict hemostasis and asepsis can reduce these complications.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21061

scholarly journals HYSTERECTOMY

2012 ◽  
Vol 19 (02) ◽  
pp. 214-221
Author(s):  
M. IKRAM ◽  
SHAZIA JABEEN ◽  
M. SAEED
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Group A ◽  
Wound Discharge ◽  
The Mean ◽  
Group B ◽  
Laparoscopic Assisted

Abdominal hysterectomy, the procedure by which almost 90% of hysterectomies are currently being done. Laparoscopicassisted vaginal hysterectomy has been introduced as an alternative to abdominal hysterectomy, and is thought to allow a more rapid return tonormal activity. Laparoscopic assisted vaginal hysterectomy has less postoperative morbidity and quicker recovery than abdominalhysterectomy. Objective: To compare the laparoscopic assisted vaginal hysterectomy with total abdominal hysterectomy in term of operativetime, per operative blood loss and post-operative wound infection. Study Design: Randomized trial. Setting: This study was carried out in thedepartment of obstetrics and gynaecology, Shaikh Zayed Hospital, Lahore. Period: Six months (15th September, 2008 to 15th March 2009).Patients and methods: Eighty patients fulfilling the inclusion criteria were selected for this study. Patients were equally divided in two groups;group A (laparoscopic assisted vaginal hysterectomy) and group B (total abdominal hysterectomy). Operative time (in minutes), blood loss (inml) as estimated and post-operative wound infection was assessed by presence or absence of wound discharge, redness and edema aroundthe incision on 3rd, 5th and 7th post-operative day. Results: The mean ages of women in group A was 49.13+4.26 and 45.68+4.54 years ingroup B. The maximum number of parity between 3-4 was 19 in group A and 20 in group B. Mean weights of cases in group A was 65.60+10.45kilograms and 70.77+15.59 kilograms in groups B. The per-operative time in group A was 105.13+6.55 minutes and 83.38+14.82 minutes ingroup B. The mean blood loss in group A was 178.0+43.51 ml and 228.25+72.49 ml in group B. The wound discharge was not found in group A,while in group B, 4 cases (10%) on 3rd post-operative day, 6 cases (15%) on 5th post-operative day and 11 cases 27.5% on 7th post-operative.Conclusions: Laparoscopic assisted vaginal hysterectomy has a quicker post-operative recovery but at the expense of a bit long duration ofsurgery. Laparoscopic vaginal assisted hysterectomy is a feasible option in a selected group of patients who would otherwise require anabdominal hysterectomy. The drug requirement to control pain and level of pain experienced by patients were also significantly less.

scholarly journals A comparative study of laparoscopic assisted vaginal hysterectomy versus total abdominal hysterectomy in benign gynaecological conditions

2021 ◽  
Vol 10 (4) ◽  
pp. 1540
Author(s):  
Pandala Sravanthi ◽  
D. Shivani ◽  
Naga Jyothi Gunturu
Keyword(s):  
Blood Loss ◽  
Return To Work ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Early Recovery ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Duration Of Surgery ◽  
Discharge From Hospital ◽  
Laparoscopic Assisted

Background: Laparoscopic assisted vaginal hysterectomy (LAVH) has become an alternative to Total Abdominal Hysterectomy (TAH) in cases difficult to manage via vaginal route. To compare the TAH and LAVH for benign uterine pathology.Methods: This prospective study conducted with the outcomes of Laparoscopic assisted vaginal hysterectomy with Total abdominal hysterectomy over a period of 2 years in 100 patients who are undergoing hysterectomies for benign uterine pathology. 50 underwent TAH and 50 underwent Laparoscopic Assisted Vaginal hysterectomy.Results: The average duration of surgery in TAH group is 50 minutes and it is 75 minutes in LAVH group (P<0.05). In TAH group, blood loss was more (250-500ml) in 28% of patients, where as it was <250 ml in 92% of patients in LAVH group. Mean blood loss is 238 ml and 130 ml in TAH and LAVH group (P<0.01). Only 3 (6%) patients in LAVH group required blood transfusion (P>0.05). Recovery and return to work after discharge from hospital was early with LAVH group as early. Recovery and return to work after discharge from hospital was early with LAVH group as early as 2 weeks in 46% of patients. In TAH group, it was late by 4 weeks in 52% of patients and by 6 weeks in 10% of patients.Conclusions: Thus, it can be concluded that LAVH is safe with less blood loss, shorter duration of hospital stay, early recovery to work, and other intra-operative and post-operative complications. 

scholarly journals Vesico-Vaginal Fistula Repair Through Abdominal Approach

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 129-132
Author(s):  
Hafiz Al Asad ◽  
Asif Yazdani ◽  
Zulfia Zinat Chowdhury ◽  
Muhammad Faruk Hussain ◽  
AKM Shahadat Hossaion ◽  
...  
Keyword(s):  
Wound Infection ◽  
Operative Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Vaginal Fistula ◽  
Abdominal Approach ◽  
History Of ◽  
Vesico Vaginal Fistula

Background: Vesico-Vaginal Fistula (VVF) is a major cause for concern in many developing countries with significant morbidity. Among the different techniques abdominal approach of VVF repair is important one. Objective: To find out the outcome of VVF repair by abdominal approach. Materials and Methods: It is a prospective study. Twenty-three patients with VVF were operated with abdominal approach from the period of January 2016 to January 2019. Age of patients, co-morbidities, cause, size and location of VVF were evaluated. Then abdominal approach of VVF repair was done. Operative time and need of blood transfusion were encountered. Post operative (POD) urine leakage, wound infection or other complications were enlisted. Patients were discharged with keeping urethral catheter for 14 days. Follow up was done after 1 and 3 month and in each follow up history and physical examination was done. All collected data were evaluated. Results: Mean age of the patient was 40 years. Among the 23 patients 12 (52%) patients had history of total abdominal hysterectomy, 9 had history of caesarian section and 2 cases had history of pelvic surgery. VVF repair was done at least 12 weeks after its occurrence. Operative time ranged from 90 minutes to 150 minutes. In the immediate POD no obvious complications were noted except one patient developed wound infection on 7th POD. Follow-up done as per schedule and no recurrence of VVF noted. Conclusion: VVF repair through abdominal approach is a feasible, safe and effective technique if performed meticulously. KYAMC Journal Vol. 11, No.-3, October 2020, Page 129-132

scholarly journals The route of hysterectomy: a comparative study between abdominal hysterectomy (AH), non descent vaginal hysterectomy (NDVH), and laparoscopic assisted vaginal hysterectomy (LAVH)

2018 ◽  
Vol 7 (10) ◽  
pp. 4022 ◽  
Author(s):  
Prashaant Uikey ◽  
Trupti M. Wankhede ◽  
Megha P. Tajne
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Clinical Results ◽  
Abdominal Hysterectomy ◽  
P Value ◽  
Vas Score ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Hysterectomy is the most common operation performed by the gynaecologist. The uterus can be removed using any of the technique and approaches, including abdominal, vaginal, laparoscopic. There are no formal guidelines available regarding the most appropriate route of hysterectomy. Hence, a comparison of the clinical results of the three routes of hysterectomy is needed.Methods: a prospective study was performed at Indira Gandhi government medical college Nagpur between September 2015- October 2017, among 150 women indicated to undergo hysterectomy for benign and mobile uterine conditions. They were assigned 50 each to three routes of hysterectomy (abdominal, non-descent vaginal hysterectomy and Laparoscopic assisted vaginal hysterectomy). Outcome measures including operating time, blood loss, fall in haemoglobin, intra-operative complications, duration of analgesia, VAS score, hospital stay and post-operative morbidity were assessed and compared between the three groups.Results: Fibroid uterus (65.33%), was the commonest indication for hysterectomy. As far as operating time, intra-operative blood loss, fall in haemoglobin, duration of analgesia, VAS score and hospital stay P Value was significant among the three group. Incidence of complications was least in the NDVH group.Conclusions: In developing country like India with poor health care resources, scarcity of beds and non-availability of sophisticated equipment NDVH offers a distinctive advantage over other route of hysterectomy and should be the route of choice for benign uterine conditions.

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