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 hysterectom y, Twenty-four attended for a further scan at clinical follow up, Vagi nal vault fluid collections were identified in 19 women (59%) on the f irst post-operative scan, Fifteen of the 19 with collections had no si gnificant pyrexia. Out of the entire sample of 32 subjects, six patien ts (19%) had significant post-operative pyrexia of whom four were in t he group with post-hysterectomy vaginal vault collection and two had n o collection on their early post-operative scans, All collections dete cted 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 sc an. No statistically significant association was demonstrated between the presence of a collection and post-operative pyrexia, surgical appr oach or operative blood loss, The results of this study indicate that the demonstration of vaginal vault collection following hysterectomy i s a frequent finding in both febrile and afebrile subjects and does no t indicate the need for drainage.