Vaginal hysterectomy vs abdominal hysterectomy.

This was a prospective study, conducted to analyze the intraoperative complications, postoperative morbidities and complications between abdominal and vaginal hysterectomy. This study was carried out on 100 patients (50 cases abdominal and 50 cases vaginal hysterectomy), in Services Hospital, Lahore in the year 2002 from April to December. Among the intraoperative observation, the mean duration of surgery of abdominal hysterectomy was 96.8 min and that of vaginal was 89 min (p=0.0192). The mean blood loss in abdominal hysterectomy was 311 ml and that in vaginal hysterectomy was 244ml (p=0.0017). Postoperatively febrile morbidity was seen in 10 (20.0%) cases of abdominal hysterectomy group and 6 (12.0%) of vaginal hysterectomy group. Wound infection was the main cause for febrile morbidity in abdominal hysterectomy group where as urinary tract infection was the main cause for febrile morbidity in vaginal hysterectomy. There was one case of bladder injury and 1 case of ureteric injury in abdominal hysterectomy group while none in vaginal hysterectomy group. There were 2 (4.0%) cases of postoperative haemorrhage in abdominal hysterectomy group and none in vaginal hysterectomy group. Vault infection occurred in 2 (4.0%) cases of both the groups. Two (4.0%) cases of paralytic ileus, 2 (4.0%) cases of chest infection and 1 (2.0%) case of rectal muscle hematoma were seen in abdominal hysterectomy group. Overall 39 (78.0%) cases of abdominal hysterectomy and 1 (32.0%) case of vaginal hysterectomy had complications (p=0.0002). This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative morbidities and complications as compared to abdominal hysterectomy.

An overview of reproductive health of women in Bajhang district.

Reproductive health is not merely an absence of disease or disorder, rather it is a condition in which reproductive process is accomplished in a state of complete physical, mental and social well being according to WHO. Reproductive morbidity encompasses obstetric morbidity including conditions during pregnancy, delivery and the post-partum period; and gynecological morbidity including conditions of the reproductive tract such as reproductive-tract infections, cervical cell changes, genital prolapse, malignancies and infertility. The first step towards achieving the needs of women as consumers and providers is to do baseline research so that the nature and magnitude of the problem is assessed. Bajhang is one of the poorest, most deprived and remotest districts in the Far Western development region of Nepal. The status of all women is very low and their situation is very difficult. This study was conducted during a gynecological camp for a period of six days from 10th-15th March, 2003, in the district hospital of Bajhang at Chainpur. All women who attended the gynecological camp were included in the study. The 6 days period, total 530 women had attended the camp. Among them 273 (51.5%) had gynecological problems. Uterovaginal prolapse was the leading morbidity found in 97 women (18.3%) followed by subfertility (14.2%) and reproductive tract infections(13.9%). Only 22.0% women were using family planning methods. This study shows that a large number of women are seeking help for gynecological problems, hence emphasizing the importance of research in this area. Such studies have a pronounced impact in settings where no information on gynaecological morbidities exists and where there is an absence of consensus on the extent of such morbidity. This study not only gives us a baseline data about the most prevalent gynaecological problems in the remote area, it may help us in planning future reproductive health programs also.