Browsing by Author "Ekanayake, C. D."

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    Hysterectomy for benign uterine conditions: Cost evaluation, post procedural quality of life and pelvic organ function.
    (University of Kelaniya, 2019) Ekanayake, C. D.
    OBJECTIVE: The Objective was to assess costing, quality of life and pelvic organ function in women undergoing total abdominal hysterectomy (TAH), non-descent vaginal hysterectomy (ND VH) and total laparoscopic hysterectomy (TLH) for benign uterine indications. METHODS: A randomized controlled trial* was done in two public sector hospitals. Eligible participants were patients requiring hysterectomy for non-malignant uterine causes. The exclusion criteria were; uterus>14 weeks, previous pelvic surgery, those requiring incontinence surgery or pelvic floor surgery, any medical illness which cautioned/contraindicated laparoscopic surgery. A societal perspective with micro-costing for direct hospital costs was used to calculate costs. Time to recover and the difference in utility scores (EQ-5D-3L questionnaire) were used to assess quality of life. Pelvic organ function was assessed using validated ICIQ-VS, ICIQ-FLUTS questionnaires and an interviewer based questionnaire for bowel symptoms. RESULTS: The operative time was significantly more in TLH (93 (80-111) compared to TAH 45 (36.5-60) and ND VH 50 (35-65) (p<0.01). The post-operative hospital stay was shorter in the TLH 2 (1-3) compared to TAH 3 (2-3) and NDVH 3 (2-3). The total cost [(interquartile range), number] of TAH was USD 338 [(310-408), n=49] versus USD 334 [(297-414), 11=49] for NDVH and USD 412 [(364-460), 11=49] for TLH (p