Abdominal Vs Vaginal Hysterectomy: A Comparative Study Of The Postoperative Patient Satisfaction

Abstract

Hysterectomy is one of the most commonly performed gynecological procedures, with abdominal and vaginal approaches being widely utilized. While abdominal hysterectomy (AH) is traditionally more common, vaginal hysterectomy (VH) has been associated with lower morbidity, reduced hospital stays, and faster recovery. This study aims to compare the postoperative outcomes, quality of life, and patient satisfaction between VH and AH. This randomized controlled trial was conducted at the Department of Obstetrics & Gynecology, Lady Willingdon Hospital, Lahore. A total of 100 females, aged 25-65 years and undergoing hysterectomy for abnormal uterine bleeding, were randomly assigned to two groups: Group A (VH, n=50) and Group B (AH, n=50). Key intraoperative parameters such as operative time and intraoperative blood loss were recorded, while postoperative recovery was assessed using hospital stay duration, pain score (SF-36), functional capacity, and quality of life scores. Patient satisfaction was evaluated after one month. Data were analyzed using SPSS v.25, with independent samples t-test and chi-square test used for statistical comparisons. A p-value ≤0.05 was considered statistically significant. Baseline demographic and clinical characteristics were comparable between the two groups (p > 0.05 for age, BMI, parity, socioeconomic status, and education level). VH was associated with significantly shorter operative time (75.3 ± 12.5 min vs. 98.6 ± 15.2 min, p < 0.001) and lower intraoperative blood loss (210.5 ± 50.3 mL vs. 320.7 ± 65.1 mL, p < 0.001) compared to AH. Postoperatively, VH patients had a shorter hospital stay (2.3 ± 0.8 days vs. 4.5 ± 1.1 days, p < 0.001) and reported significantly lower pain scores (85.4 ± 10.5 vs. 62.3 ± 12.8, p < 0.001). Functional capacity and physical aspect scores were also significantly higher in VH patients (p < 0.001), indicating better recovery. Moreover, patient satisfaction was significantly greater in the VH group (90.0%) compared to the AH group (65.5%, p = 0.002), with quicker return to normal activities (3.5 ± 1.2 weeks vs. 5.8 ± 1.5 weeks, p < 0.001). Vaginal hysterectomy demonstrated superior postoperative outcomes, including shorter operative time, reduced intraoperative blood loss, faster recovery, lower pain levels, and greater patient satisfaction, compared to abdominal hysterectomy. These findings support the preference for vaginal hysterectomy when feasible and highlight its role in improving patient quality of life and surgical efficiency. Further multi-center trials with extended follow-up are recommended to validate these findings.