The incidence and significance of acute post-hysterectomy pelvic collections

Slavotinek, John; Berman, Laurence; Burch, Draion M.; Keefe, Bernadette

doi:10.1016/s0009-9260(05)83425-7

Cited by 28 publications

(20 citation statements)

References 6 publications

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“…The collection rate was reported as a range from 34 to 66% for the closed operation and 40% for the open cuff procedure and the infection rates was high in the open procedure 23,24 . The absent of abscess, cellulites or fistulas on both groups comproved the adequacy of the animal model and the performance of surgical technique.…”

Section: Discussionmentioning

confidence: 99%

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

et al. 2009

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Purpose:To investigate the effectiveness of fibrin glue in comparison with polyglycolic acid suture to promote the closure of rabbit's vaginal vault, after abdominal hysterectomy. Methods: Twenty female, adults, New Zealand rabbits, were submitted to abdominal hysterectomy and randomly distributed to polyglycolic acid suture (G-PA / n=10) or fibrin glue closure of vaginal vault (G-FG / n=10). Radiograph study allowed identifying vault vaginal suture disrupter or fistulas to urinary bladder or rectum. Videovaginoscopy study allowed identifying the presence of cellulites, abscess formation, tissue granulation or granuloma. Vaginal cuff burst test allowed to identify by the escape of air bubbles and rupture pression record. Histological sections stained with Picrosirius red allowed the measure of fibrous tissue healing. Results: The videovaginoscopy identified a significant difference (Fisher Test p<0.3142) of granulation tissue in the animals of G-PA (40%) in comparison with the G-FG (20%). The gross inspection showed the same relation in the granulation tissue occurrence (Fisher test p< 0.1749) with G-PA (50%) and G-FB (20%). The visceral adhesion to the vaginal vault wound was statistical significant (Fisher test p< 0.1749) with G-PA (50%) and G-FG (20%). The pressure of rupture (mm Hg) of the burst test was similar (p<0.0421) in the animals of G-PA (61.5±19.3) and G-FG (72.5±21.9). The collagen matrix of vault wound healing was similar (p< 0.0231) between the G-PA (31.63±15) and the G-FG (23.2±13.2). Conclusion: The vaginal vault closure using the fibrin glue is a safe and reliable procedure after abdominal hysterectomy in female rabbit model.

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Section: Discussionmentioning

confidence: 99%

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

et al. 2009

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“…Thomson et al (1998) found in their study (223 patients) that 25% of women had an ultrasound detected vault haematoma following vaginal hysterectomy with/without pelvic floor repair . A review of other literature has revealed that incorporating postoperative transvaginal ultrasound has shown a higher prevalence (ranging from 34 to 59%) of vault haematoma following hysterectomy, (Toglia & Pearlman 1994;Haines et al 1995;Slavotinek 1995). Kuhn and De Crespigny (1985) found 98% of their patients (50) had a vault haematoma after vaginal hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of closureversusnon-closure of vaginal vault after vaginal hysterectomy

Moustafa

Elgonaid

Massouh

et al. 2008

Journal of Obstetrics and Gynaecology

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This randomised prospective study in 53 women having vaginal hysterectomy for benign conditions compared a closed vault technique with an open technique. Twenty-seven had the vault closed (group A) whereas 26 patients had an open vault (group B). The primary outcomes include, vault haematoma (as detected by ultrasound on day 3) and fever. Secondary outcomes are haemorrhage, urinary tract infection, urinary retention and vault granulation tissue. The study did not show any statistical difference between either group. Prolapse of the fallopian tube was recorded in one case in the open vault group. A randomised controlled study on a larger scale is recommended.

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“…11,12 There is in fact a wide variation in the published rates of vault collections after different hysterectomies. [6][7][8][9] Hematomas are often asymptomatic and as such clinically insignificant, which further confounds interpretation of the literature. 8 The practical implication of both our results and the published data is that at least 300 to 400 women would have to be randomized to laparoscopic and nonlaparoscopic hysterectomy to identify a 50% reduction in vault collections with laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Routine viewes included coronal, sagittal, and oblique planes. Our definition of a collection was a fixed circumscribed fluid or semifluid mass of different acoustic reflectivity in contact with or close to the vaginal vault, such as that previously described by Slavotinek et al 9 Statistical analysis was performed using Fisher's exact test, chi-square test, and unpaired t test.…”

Section: Methodsmentioning

confidence: 99%

“…7,8 Despite the perception that vault hematomas can delay recovery after surgery, there is little agreement in the literature on their incidence; when ultrasound was used to detect acute posthysterectomy pelvic collections, the reported prevalence ranged from 25% to 98%. [6][7][8][9] More specifically, there is no information about their relative incidence after different types of hysterectomies. This is a relevant issue in the current debate about which is the "best" hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

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

Miskry¹,

Chatzipapas²,

Mb³

et al. 2001

Journal of Gynecologic Surgery

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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 5 0.02). Vaginal vault collections were relatively uncommon, often asymptomatic, and similar between the three routes of hysterectomy. (J GYNECOL SURG 17:87, 2001)

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The incidence and significance of acute post-hysterectomy pelvic collections

Cited by 28 publications

References 6 publications

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

Evaluation of closureversusnon-closure of vaginal vault after vaginal hysterectomy

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

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