Subtotal versus total abdominal hysterectomy

Abstract EN

Objectives: To study subtotal compared to total hysterectomy.

Design: Retrospective, comparative analysis.

Setting: King Abdulaziz University Hospital.

Subjects: Consecutive forty four patients undergoing subtotal and ninety patients undergoing total abdominal hysterectomy for benign indications were included in this study.

Intervention: Patients were subjected to either subtotal or total abdominal hysterectomy according to anticipated technical difficulty providing that all previous cervical smears had been normal.

Main outcome measures: Various intra-operative and post-operative variables, hospital stay, urinary and sexual morbidity.

Results: A total of 134 patients were studied.

Menorrhagia was the dominant indication for surgery in 89.5%, dysmenorrhoea was present in 38.7% followed by pelvic and back pain in 35.8%.

Fibroids were present in 58.2% of patients.

There was no statistically significant difference in the intra or post-operative complication rate except for wound bruising which was a more significant event in total than subtotal hysterectomy.

There was no statistically significant change in urinary frequency and nocturia in both groups.

A significant improvement in the symptoms of dyspareunia, coital desire and frequency was observed in the total, but not so in the subtotal hysterectomy group.

Conclusion: This study demonstrated a better overall sexual outcome in total abdominal hysterectomy but no significant difference in urinary symptoms with both