THE INCIDENCE AND SIGNIFICANCE OF ACUTE POST-HYSTERECTOMY PELVIC COLLECTIONS

In a prospective study, 32 consecutive patients underwent endovaginal pelvic scanning in the first post-operative week following hysterectomy, Twenty-four attended for a further scan at clinical follow up, Vaginal vault fluid collections were identified in 19 women (59%) on the first post-operative scan, Fifteen of the 19 with collections had no significant pyrexia. Out of the entire sample of 32 subjects, six patients (19%) had significant post-operative pyrexia of whom four were in the group with post-hysterectomy vaginal vault collection and two had no collection on their early post-operative scans, All collections detected on the early scans had resolved or were smaller on follow-up scan but two asymptomatic patients who had no collection on the early scan had developed vaginal vault fluid collections on the late followup scan. No statistically significant association was demonstrated between the presence of a collection and post-operative pyrexia, surgical approach or operative blood loss, The results of this study indicate that the demonstration of vaginal vault collection following hysterectomy is a frequent finding in both febrile and afebrile subjects and does not indicate the need for drainage.