An Audit of Vaginal Hysterectomy and Pelvic Floor Repair for Uterovaginal Prolapse in South‑East Nigeria

Abstract

Aim: The study aimed to audit vaginal hysterectomies and pelvic floor repair performed for women with uterovaginal prolapse as a quality
assessment of the procedure.

Materials and Methods: In this study conducted at the National Obstetric Fistula Center, Abakaliki, case folders of women who had vaginal  hysterectomy and pelvic floor repair for uterovaginal prolapse between June 2012 and December 2016 were reviewed. Relevant data were extracted using a pro forma and analyzed using the Statistical Package for the Social Sciences, software version 21.

Results: The case records of 358 women who had a vaginal hysterectomy and pelvic floor repair were reviewed. Their mean age and parity were 53.44 ± 10.54 years and 6.92 ± 2.47, respectively. Complications were recorded in 49 (14%) of the patients, and these were intraoperative bleeding requiring blood transfusion in 15 (4.2%), postoperative intraabdominal bleeding requiring exploratory laparotomy in 7 (2%), urinary tract infection in 5 (1.4%), hospital re‑admission following vaginal bleeding in 2 (0.6%), and vaginal discharge in 13 (3.6%). The long‑term complication that was  observed following the procedure was vault prolapse in 7 (2%). There was 1 (0.3%) mortality.

Conclusion: Vaginal hysterectomy with pelvic floor repair is a relatively safe procedure in women with uterovaginal prolapse. There are morbidities associated with this procedure.

Keywords: Audit, pelvic floor repair, uterovaginal prolapse, vaginal hysterectomy, vault prolapse