A prospective cross-sectional study involving 14 government hospitals was undertaken for a period of 6 months in Malaysia to study the patterns of hysterectomy for gynaecological indications. A total of 707 patients were enrolled in the study consisting of 612 abdominal hysterectomies and 95 vaginal hysterectomies. Fibroids (47.6%) and uterovaginal prolapse (13.4%) formed the main indications for surgery. The initial preoperative diagnosis was accurate in 82.8% of cases. A different pathology from that initially suspected was noted in 118 cases. The overall complication rate was 7.9% but vaginal hysterectomies carried a statistically higher complication rate compared to abdominal hysterectomies. Urinary tract infection was significant in vaginal hysterectomies. Blood transfusion was required in 25.0% of abdominal and 6.3% of vaginal hysterectomies. There were no laparoscopic hysterectomies or mortality in this series.
Comment in: Soh EB, Ng KB. A survey of hysterectomy patterns in Malaysia. Med J Malaysia. 1999 Mar;54(1):152-4; Teoh TG. Hysterectomies in Malaysia: why are we left behind? Med J Malaysia. 1999 Mar;54(1):151-2
Vaginal vault prolapse after hysterectomy is a distressing complication for both the patient and the surgeon. Successful repair of post-hysterectomy vault prolapse is one of the most difficult problems in gynaecological surgery. The aim of the surgery should be to restore coital function and cure the prolapse permanently.