Long term complications of vaginal hysterectomy: a case control study.

Objective: Our purpose was to evaluate the long term sequelae after vaginal hysterectomy.

Study Design: A retrospective case control study to evaluate the long term complications after vaginal hysterectomy compared with control patients who had during the same period undergone cholecystectomy for benign pathology. Excluded were hysterectomies during which adnexectomy or treatment of prolapse, stress incontinence or genital cancer was also effected. We selected 221 patients who had undergone simple vaginal hysterectomy and 232 where cholecystectomy had been performed. The questionnaire listed 149 questions that dealt with matching characteristics and queries relating to symptoms.

Results: 117 questionnaires suitable for analysis were received from the patients in the hysterectomy group and 95 from the cholecystectomy group. After the matching process 61 patients who had a simple vaginal hysterectomy and 58 who had undergone cholecystectomy were selected. After simple vaginal hysterectomy there was a significant worsening of all urinary problems, of digestive problems and sexual intercourse. After cholecystectomy there is also an increase in the severity of most symptoms surveyed.

Conclusion: Many long-term complications following hysterectomy cannot be attributed to the intervention. Vaginal hysterectomy should not be considered as being responsible for major complications appearing during the first 4 years of follow-up.