A Prospective Randomized Comparative Study of Vaginal, Abdominal, and Laparoscopic Hysterectomies.

PURPOSE: The present study is a prospective, randomized comparative study of abdominal, vaginal and laparoscopic hysterectomies comparing various parameters such as indications, blood loss, post operative pain, time taken for surgery, intraoperative and postoperative complications and total hospital stay.

MATERIALS AND METHODS: 50 patients were selected in each group over a period of 18 months. The patients were selected in such a way that they could be operated by all 3 routes. Thus patients undergoing hysterectomy for non malignant conditions, having no adnexal masses, having no severe endometriosis, uterine size not more than 12 weeks and uterine descent of not more than 1st degree were selected.

RESULTS: The most common indication for hysterectomy was found to be DUB, the maximum time taken was in TLH, the minimum blood loss was found in TLH. There was significant difference in the pain scores using VAS among the three groups on day 0 and day 1, where the scores were significantly lower in VH group, the hospital stay was maximum in TAH group while there was no difference between VH and TLH groups.

CONCLUSION: TLH is a better alternative for TAH and with good equipment, expertise and excellent teamwork TLH will be the future candidate for mode of surgery.