An audit of vaginal hysterectomies at the University College Hospital, Ibadan.

Background: Cost reduction, less postoperative morbidity and absence of abdominal scars are advantages of vaginal hysterectomy. The study aimed to examine the rate, indications, and complications of vaginal hysterectomies performed at University College Hospital Ibadan to derive lessons for the immediate future.

Methods: An analysis of the records of all vaginal hysterectomies performed from 1995-2004. Information on the patients' epidemiological characteristics, indications and details of surgery performed, length of duration of surgery and postoperative course was retrieved. Data was analyzed with Stata-11 software.

Results: Vaginal: abdominal hysterectomy ratio was 1:9, the former constituting 2.3% of major gynaecological operations done. The mean age of patients was 56.6 +/- 12.9 years and most were grandmultiparous. Twenty-two cases (81.8%) were due to genital prolapse. No uteri were larger than 12 weeks' size. Most (78.1%) were performed by consultants. Complication rate was 63.0%; the most frequent was intra-operative haemorrhage. Mean hospital stay was 7.4 +/- 3.5 days. Post-operation anaemia was associated with longer hospital stay (p = 0.02).

Conclusion: With increasing detection rate of CIN, lesser parities and the availability of the operating laparoscope at our centre, there is need to widen case selection beyond genital prolapse (in view of known benefits of vaginal hysterectomy) for renewed skill acquisition to reduce the high complication rates and for better training of resident doctors.