Bleeding associated with vaginal hysterectomy

The Australian & New Zealand Journal of Obstetrics & Gynaecology
C WoodD Hill

Abstract

The increased use of blood transfusion, ultrasound evidence of postsurgical haematoma, the frequency of postoperative febrile morbidity of unknown cause and reports of these complications in large series which contain both abdominal and vaginal hysterectomy over the last 25 years, suggests that bleeding may be more common after vaginal hysterectomy. We performed laparoscopy routinely after vaginal hysterectomy in 50 patients. The frequency of bleeding was 48%, consistent with other studies ranging from 30 to 98%. Arterial bleeding from a branch of the uterine or vaginal artery occurred in 20%. The frequency of bleeding was not related to uterine size, ranging from normal to that equivalent in size to that of a pregnancy of 18 weeks' gestation. The most common site of bleeding was the vaginal vault. Liberal definitions of haemorrhage, possible emphasis in speed in performing hysterectomy, and difficulty in visualizing and ligating major and minor blood vessels, may have contributed to the increased frequency of bleeding reported after vaginal hysterectomy. Haemostasis is more easily obtained at laparoscopic surgery because of magnification, close inspection, routine use of suction irrigation and bipolar electrocoagulation. Routi...Continue Reading

References

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Citations

Apr 23, 2013·Best Practice & Research. Clinical Obstetrics & Gynaecology·Bhaskar D Goolab
Dec 7, 2013·International Urogynecology Journal·G ThiagamoorthyD Robinson
Aug 11, 2005·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A SinhaR Sinha
Feb 19, 1999·Baillière's Clinical Obstetrics and Gynaecology·C Wood, P Maher
Jul 20, 2007·BJOG : an International Journal of Obstetrics and Gynaecology·F Alfhaily, A A A Ewies
Oct 25, 2000·Hospital Medicine·A J Thomson, R G Farquharson
Jan 15, 2002·The Australian & New Zealand Journal of Obstetrics & Gynaecology·G R OttonA D Hewson
Jan 16, 1999·The Australian & New Zealand Journal of Obstetrics & Gynaecology·C Wood, P Maher
Oct 7, 1998·The Australian & New Zealand Journal of Obstetrics & Gynaecology·P P Petros
Apr 1, 2017·Gynecology and Minimally Invasive Therapy·Soo-Jeong LeeYong-Soon Kwon
May 23, 2018·International Urogynecology Journal·Wenjin ChengJianliu Wang

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