A Retrospective Review of Abdominal Hysterectomy in a Teaching Hospital

Abstract

INTRODUCTION: Hysterectomy is the most commonly performed gynaecological surgery throughout the world. It may be life saving procedure in acute uterine hemorrhage; whereas improves the quality of life in a patient with certain uterine pathology such as fibroids, endometriosis and uterine prolapse. The objective of this study is to review the indications and complications of abdominal hysterectomy as well as to assess the correlation of preoperative clinical and ultrasonographic diagnosis with histopathology of hysterectomy specimens. MATERIAL AND METHODS: A retrospective review of medical records of patients who underwent abdominal hysterectomy between January 2010 and July 2012 in the College of Medical Sciences Teaching Hospital, Nepal was done. Various demographic and pertinent clinical informations were retrieved. Clinical presentations, indications and complications of the hysterectomy as well as the correlation between the clinical diagnosis, ultrasound findings and histopathological diagnosis of the hysterectomy specimen was studied. RESULTS: Between January 2010 and July 2012 a total of 139 patients had undergone abdominal hysterectomy for various indications. The mean age at the time of hysterectomy was 45.5 years. Abnormal vaginal bleeding and lower abdominal pain were the main presenting complaints. The median duration of symptoms was 12 months. Fourty three (40%) had hysterectomy alone and 96 (60%) had hysterectomy with salpingo oophorectomy. The most common clinical indication for hysterectomy was fibroid uterus (40.3%) followed by benign ovarian tumor (18.7%) and dysfunctional uterine bleeding (17.3%). There were no major postoperative complications. The correlation between clinical diagnosis and histopathology was significant at 0.01 level using Pearson correlations. CONCLUSION: Uterine fibroids and benign ovarian tumors are the common indications for abdominal hysterectomy. Postoperative complications are minimal and most of the time the clinical diagnosis correlates with the postoperative histopathological diagnosis.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Pages 16-19

Study On Clinical Profile of Patients Undergoing Abdominal Hysterectomy and Their Clinico-Pathological Correlation

“…[7][8][9] In our study the commonest age group undergoing abdominal hysterectomy was between 41-50. This result is comparable with the study done by Prusty RK, Choithani C et al 10 The mean age of patients was 46.34±7.82, similar to research conducted in other regions of Nepal by Jha R et al and Acharya S et al 11,12 More than 90% of cases were parity two and above and only 3 cases(2.7%) were nulliparous which was also reported in the study done by Acharya S et al 12 Abnormal menstrual flow and pain abdomen were the two main complaints seen in our study each presenting 46.8% and 40.5% respectively. Abnormal menstrual flow, as the single most common symptom, in patients undergoing abdominal hysterectomy is stated in various studies.…”

A Clinico-histopathological Correlation of Elective Abdominal Hysterectomy in University Hospital

“…This finding was similar to previous studies. [2][3][4][5][6][7] In the present study, the maximum number of 110 (54.19%) patients was seen with parity 2-3 which was comparable to other studies. 3,8 The most common clinical symptom in this study was menorrhagia found in 67 (33.00%) patients followed by pain abdomen in 62 (30.54%) patients which were similar to the studies done by Jaleel R, Perveen S and Naheed K. 2,6,9 It is well known that hormonal disturbance in the perimenopausal age group, results in symptomatic menstrual changes.…”

“…3,8 The most common clinical symptom in this study was menorrhagia found in 67 (33.00%) patients followed by pain abdomen in 62 (30.54%) patients which were similar to the studies done by Jaleel R, Perveen S and Naheed K. 2,6,9 It is well known that hormonal disturbance in the perimenopausal age group, results in symptomatic menstrual changes. 6 In this study, the most common preoperative diagnosis for hysterectomy was leiomyoma uterus found in 105 (51.72%) patients followed by ovarian tumor in 34 (16.75%) patients which were similar to the results reported by Acharya S. 7 Jha R. found that leiomyoma was the indication in 24.9%, ovarian tumor in 14.9%, and DUB in 7.7% of the cases. 10 Similar results were observed in the studies done by Yadav DP, Jaleel R and Naheed K. 2,3,9 In our study, the most common histopathological diagnosis was leiomyoma, found in 87 (42.86%) patients, as similar to other studies.…”

“…2,4,10,11 In this study, the correlation between preoperative diagnosis and histopathological diagnosis was 100.00% in cases of ovarian tumor, complex endometrial atypical hyperplasia, PID, fibroid polyp and chronic cervicitis whereas it was 96.55% in ovarian cyst and 82.86% in leiomyoma, comparable to previous studies. 3,7,10,12 However, double pathologies of leiomyoma and adenomyosis coexisted in 11 patients (10.47%). Adenomyosis was found in 5 patients (4.77%) with preoperative diagnosis of leiomyoma while acute endometritis was found in 1 patient (0.95%) whereas no pathology was identified in 1 patient (0.95%) in histopathological diagnosis.…”

“…These findings were consistent with previous studies. 5,7 Many times, histopathological examination of hysterectomy specimens does not reveal any pathology. 10 In our study, 9 (4.43%) patients had unremarkable pathology who were operated with preoperative diagnosis of AUB (6 cases), leiomyoma uterus (1 case) and postmenopausal bleeding (2 cases).…”