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PREVALENCE OF VAULT PROLAPSE AFTER HYSTERECTOMY

Dr Naeem Akhtar Khokhar, Dr Tahira Parveen Mahar, Dr Asifa Abdul Jabbar, Dr Shabana Bano Soomro, Dr Tahira Parveen Awan, Dr Farzana Baloch

Objective: To determine the frequency of vault prolapse after hysterectomy in patients presenting with incontinence and vaginal bleeding. To compare the frequency of vault, prolapse after abdominal vs vaginal hysterectomy. Subject and Methods: The design of this study is Cross-Sectional Study. This study was conducted in the Department of Obstetrics and Gynecology at S.Z.W. Hospital, Larkana and this study was done in six months from April 15, 2016 to October 15, 2016. A total of 335 post-menopausal Women since 2 months presenting with incontinence and vaginal bleeding were included in this study. A standardized pelvic examination was performed to evaluate the site and degree of pelvic relaxation with a Pelvic Organ Prolapse Quantification. Vaginal vault prolapse was graded on a 0 to 4 scale. All information was entered into pre-designed proforma. Results: - The average age of the women was 58.90±5.44 years. Frequency of vault prolapse after hysterectomy in patients presenting with incontinence and vaginal bleeding was observed 19.4% (65/335). Rate of vault prolapsed was significantly high in those women who had abdominal hysterectomy as compare to those with viginal hysterectomy (p=0.026). Conclusion: Before doing surgery of patients who need abdominal or vaginal hysterectomy, we have to decide properly the route of the surgery specially in those patients with mild to moderate degree of prolapse. In patients having large size of uterus due to any cause and with prolapse of any degree TAH should be decided followed by proper tying of supporting ligaments by different methods, so that we can prevent the vault prolapse in those patients. KEYWORDS: Vault Prolapsed, Hysterectomy, Vaginal Bleeding