Comparative Analysis of Postoperative Complications in Total Abdominal Vs. Vaginal Hysterectomy: At the General Hospital of Cancun "Dr. Jesús Kumate Rodríguez" (January–December 2024)

Abstract

Background: Hysterectomy is one of the most frequently performed gynecological procedures worldwide and is a fundamental intervention in the management of numerous benign and malignant uterine conditions. The choice of surgical approach—abdominal, vaginal, laparoscopic, or robotic—is a critical aspect of gynecological practice, as each approach carries a different profile of risks, complications, and recovery times.

Objective: To compare the frequency and type of postoperative complications between abdominal hysterectomy and vaginal hysterectomy in patients treated at the General Hospital of Cancun “Dr. Jesús Kumate Rodríguez”, in order to generate local evidence that allows improving surgical safety and guiding institutional practice.

Materials and methods : This was an observational, retrospective, comparative, and cross-sectional study with a quantitative approach. Clinical records of all patients who underwent total hysterectomy via the abdominal or vaginal route between January and December 2024 were analyzed.

Results: A total of 78 cases of patients undergoing hysterectomy were obtained according to the surgical route —abdominal and vaginal—, the final group was 67 patients included in the analysis. The largest proportion of cases were abdominal hysterectomies, with 92.5% of the group also having the highest number of surgical complications. In contrast, the vaginal route accounts for a smaller number of procedures with 7.5% having clearly identified complications (one post-surgical hematoma and one case of urinary retention).

Conclusions: When comparing the frequency and type of postoperative complications between abdominal and vaginal hysterectomy in patients treated at the Hospital, the evidence shows that, among abdominal complications, the most frequent were bladder injury and urinary incontinence. Despite being the most frequently used approach, the majority of abdominal procedures were uncomplicated (55 cases), reflecting an acceptable relative safety rate.