[Vaginal rupture as a late complication of hysterectomy]. / Vaginaltopruptur som senkomplikation ved hysterektomi.

We report a patient with intracoital vaginal rupture two months after a hysterectomy. The case was managed successfully by simple suturing of the vaginal vault.

[Analysis of need for sick leave after hysterectomy]. / Vurdering af rekreationsbehovet efter hysterektomi.

INTRODUCTION: The recommended sick leave after hysterectomy varies among operating wards and depends on many non-medical issues. The recommendation is rarely validated scientifically and is often without any connection to the women's actual handling of the leave if this is not recorded as part of a project. We analysed the postoperative period for a group of hysterectomised women who kept a diary over eight weeks. MATERIALS AND METHODS: Between July 2005 and June 2006 all hysterectomised women entered the diary project if they fulfilled the following criteria: the operation was indicated by meno-metrorrhagia, dysplasia, pressure symptoms or pain, she was under 60, she was Danish-speaking and in full-time work which was to be recommenced after operation. Women were excluded if they were operated for descended uterus, if a major re-operation was performed or, unexpectedly, endometriosis or malignancy was found. Our ward's recommendation on sick leave was four weeks for vaginal hysterectomy and six weeks for abdominal hysterectomy, but with emphasis on the necessary individualization of sick leave. Once a week, the women answered eight questions on their well-being and activities in the diary and returned the diary. RESULTS: In total, 71 women entered the study, 27 with vaginal hysterectomy and 44 with abdominal hysterectomy. After one week, none of the women suffered from nausea or discomfort, while 20% were still complaining of pain. Less than half of the women had commenced work one week after the recommended sick leave. At that time, two thirds had recommenced their former leisure activities but less than half of the women's sex lives were as before the operation. CONCLUSION: The majority of women extend their sick leave beyond the recommended period on their own initiative, despite the ward's long recommended period of sick leave. It is questionable whether the actual period of sick leave can be cut by shortening the recommended sick leave.