effect of a modified surgical technique on the incidence of vault haematomas

ABSTRACT

To evaluate the effects of a modified incision and closure technique on the incidence of vault haematomas and post operative morbidity after vaginal hysterectomy. This study was conducted in Lady Aitchison Hospital, Lahore from November 2011 to December 2012. 100 patients aged 40 to 70 years having utero-vaginal prolapse undergoing vaginal hysterectomy were included in the study. Vaginal hysterectomy was performed with a modified Incision. Patients were observed for fever, pain and vaginal bleeding. Pelvic ultrasound was carried out for any pelvic collection or haematomas. Patients were followed for one month. Patients with complaints of lower abdominal pain, vaginal spotting, bleeding or fever were readmitted and evaluated. Out of 100 patients, 2% patients developed vault haematomas, 11% developed pain, 5% developed fever. 7% patients stayed at hospital for 5-6 days due to complications. Haematoma was confirmed by ultrasound in 2% cases and those were readmitted. Conservative management was done. No patient required surgical evacuation. Adoption of the modified technique resulted in a significant fall in postoperative morbidity due to haematoma formation.