Sonographic Comparison of Pelvic Collections After Abdominal,Vaginal,and Laparoscopic Hysterectomy

Abstract

The objective was to compare the relative incidence of early pelvic vault collections using transvaginal ultrasound after abdominal, vaginal, and laparoscopic hysterectomy, in a prospective comparative study. A transvaginal pelvic ultrasound was performed on the second and third postoperative days to determine the presence and volume of fluid collections at the vaginal vault, and febrile morbidity noted. Fifty women were studied: 15 after abdominal hysterectomy, 23 after vaginal hysterectomy, and 12 after laparoscopically assisted vaginal hysterectomy. Seven vault collections were identified (14%). No statistically significant association was identified between the presence or size of pelvic collections and the type of hysterectomy, concurrent oophorectomy, operative time, or estimated blood loss. Two of the seven women with vault collections had postoperative pyrexia (p = 0.02). Vaginal vault collections were relatively uncommon, often asymptomatic, and similar between the three routes of hysterectomy.