Vault Haematoma following Hysterectomy: Threeyear Experience

Abstract

Objectives: To examine the incidence of vault haematoma following different types of hysterectomy and to identify any risk factors related to its occurrence.
Methods: This was a retrospective analysis of patients with vault haematoma over a 3-year period (January 2012 to December 2014) at the Department of Obstetrics and Gynaecology of Pamela Youde Nethersole Eastern Hospital, Hong Kong. A total of 801 hysterectomies were performed during the above period and 56 vault haematomas
were identified. Five cases of laparoscopic-assisted supracervical hysterectomy and subtotal hysterectomy were excluded.
Results: The overall incidence of symptomatic vault haematoma was 7.04%. The occurrence of vault haematoma was associated with route of hysterectomy (p=0.03). Among routes of hysterectomy, vaginal hysterectomy was significantly associated with vault haematoma (p=0.004). Patient factors were not associated with occurrence of
vault haematoma, which included taking antiplatelet agents (p=0.99) or anticoagulants (p=0.19) that were related to a bleeding tendency, a history of diabetes mellitus (p=0.81) or menopausal status (p=0.18) that could influence wound healing ability, parity (p=0.51), history of lower segment Caesarean section (p=0.65), and uterine size (p=0.72) that
could affect degree of difficulty of operation.
Conclusion: Vaginal hysterectomy is more likely to be associated with occurrence of vault haematoma than hysterectomy performed via other routes. It is important to consider the possibility of vault haematoma in patients with persistent fever and vaginal bleeding after vaginal hysterectomy. No other definite risk factors were identified in this study.