HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Isik-Akbay, E. F. Articles by Chatwani, A. J. Search for Related Content PubMed PubMed Citation Articles by Isik-Akbay, E. F. Articles by Chatwani, A. J. Related Collections Gynecologic surgery

Hysterectomy in Obese Women: A Comparison of Abdominal and Vaginal Routes

Ebru F. Isik-Akbay, MD^*, Ozgur H. Harmanli, MD^*, Uma R. Panganamamula, MD^*, Mustafa Akbay, MD^*, John Gaughan, PhD and Ashwin J. Chatwani, MD^*

From the Departments of *Obstetrics, Gynecology and Reproductive Sciences and Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania

OBJECTIVE: To compare perioperative outcome measures of abdominal and vaginal hysterectomies in obese women.

METHODS: We reviewed the charts of all obese women (body mass index more than 30 kg/m²) who underwent abdominal or vaginal hysterectomy for benign gynecologic conditions in our institution between 1997 and 2002. Laparoscopically assisted vaginal hysterectomies and hysterectomies with concomitant major pelvic or abdominal surgery were excluded. The rate of operative and postoperative complications, length of hospitalization, operative time, and perioperative change of hemoglobin concentration were analyzed for abdominal hysterectomy and vaginal hysterectomy.

RESULTS: The study group consisted of 369 obese women, of whom 189 (51.2%) underwent abdominal, and 180 (48.8%), vaginal hysterectomy. Patient characteristics were statistically comparable between the groups except for uterine weight, which was higher in the abdominal group, and parity, which was greater for women who underwent vaginal hysterectomy (P < .05). After controlling for all the significantly different variables, vaginal hysterectomy resulted in lower incidence of postoperative fever (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.12–0.39), ileus (OR 0.21, 95% CI 0.06–0.75), urinary tract infection (OR 0.21, 95% CI 0.06–0.75), shorter operative time (126.8 ± 58.7 minutes compared with 109.7 ± 68.5 minutes) and length of hospital stay (3.5 ± 1.9 days compared with 1.9 ± 1.1 days). Seven women (3.7%) who underwent abdominal hysterectomy developed wound infections during their hospital stay compared with none in the vaginal hysterectomy group.

CONCLUSION: For obese women, vaginal hysterectomy is superior due to its lower incidence of postoperative fever, ileus, and urinary tract infection and shorter operative time and hospital stay.

LEVEL OF EVIDENCE: II-2

This article has been cited by other articles:

				S.-Y. Khong and S. Jackson Obesity and urinary incontinence Menopause Int, June 1, 2008; 14(2): 53 - 56. [Abstract] [Full Text] [PDF]

				F O The, R J Bennink, W M Ankum, M R Buist, O R C Busch, D J Gouma, S van der Heide, R M van den Wijngaard, W J de Jonge, and G E Boeckxstaens Intestinal handling-induced mast cell activation and inflammation in human postoperative ileus Gut, January 1, 2008; 57(1): 33 - 40. [Abstract] [Full Text] [PDF]