Increasing the use of the vaginal route for hysterectomy in Nigerians: A critical appraisal

Abstract

Aim: To critically assess the proportion of the abdominally performed hysterectomies that could have been done vaginally. Patients and Methods: A retrospective chart review of 283 elective hysterectomies performed at the University of Nigeria Teaching Hospital, Enugu, over a 5-year period, was undertaken. Results: The ratio of elective abdominal to vaginal hysterectomy during the study period was 2.4:1. Vaginal route was used exclusively for genital prolapse while the abdominal route was used for all the other indications. There was a high incidence of moderate to severe intrapelvic adhesions associated with large uterine fibroids, making a case against the use of vaginal route in such cases. Conclusion: It is feasible to reduce the ratio of abdominal to vaginal hysterectomy by employing the vaginal route in smaller sized fibroids and other benign uterine conditions.

Keywords

• abdominal hysterectomy; vaginal hysterectomy
• indications