Audit of hysterectomies in a group of private hospitals in Kaduna City, northern Nigeria

Onwuhafua, PI; Oguntayo, Adekunle O; Adesiyun, Gbadebo A.; Obineche, Iheonu; Akuse, J. T.

doi:10.4314/tjog.v22i1.14534

Cited by 4 publications

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“…The frequency of vaginal hysterectomy accounting for 10% of hysterectomies in our hospital is lower than findings from other centres in Nigeria where figures between 12%-23% have been quoted. [10][11][12] These rates are even lower than what has been reported from the United States (25%) and France (50%). 4,6,7 This result is indicative of the fact that vaginal hysterectomy is underutilized in our centre as compared with abdominal hysterectomy for benign gynaecological conditions.…”

Section: Discussionmentioning

confidence: 97%

“…[2][3][4][5] Vaginal hysterectomy accounts for approximately 25% of hysterectomies in the United States of America, 6 40-50% in France and Australia, 4,7,8 28% in Saudi Arabia 9 and 10-23% from various reports from Nigeria. [10][11][12][13] Uterine fibroid has been reported as the most common indication for abdominal hysterectomy and uterovaginal prolapse for vaginal hysterectomy. 4,6,[9][10][11][12][13][14] Limited or obsolete practice guidelines, safety concerns for undertaking a vaginal procedure with probable co-existing abdominal pathology, cost of vaginal hysterectomy and operator preferences for abdominal over vaginal procedures are among the documented factors for the underutilization of vaginal hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13] Uterine fibroid has been reported as the most common indication for abdominal hysterectomy and uterovaginal prolapse for vaginal hysterectomy. 4,6,[9][10][11][12][13][14] Limited or obsolete practice guidelines, safety concerns for undertaking a vaginal procedure with probable co-existing abdominal pathology, cost of vaginal hysterectomy and operator preferences for abdominal over vaginal procedures are among the documented factors for the underutilization of vaginal hysterectomy. 5,14 It has also been argued that vaginal hysterectomy may not be as technically easy among Nigerians as compared to those in developed countries because of severe pelvic adhesions frequently encountered in Nigerian women requiring hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

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Underutilization of Vaginal Hysterectomy and its Impact on Residency Training

Ocheke¹,

Cc²,

Musa³

2010

West African Journal of Medicine

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BACKGROUND: The advantages of vaginal hysterectomy over abdominal hysterectomy include lower morbidity, shorter hospital stay, and reduced cost to the patient. It is, therefore, important to pass the required skill for vaginal hysterectomy unto trainees. OBJECTIVE: To determine the proportion of vaginal hysterectomies done in a residency training institution in Nigeria and its possible impact on the proficiency of future gynaecologists in performing the procedure. METHODS: A chart review was done on all documented cases of hysterectomies for benign gynaecological conditions done in Jos University Teaching Hospital, over a four-year period (January 2002 to December 2005). Case files of patients who had hysterectomy during the study period were retrieved and the relevant information obtained for analysis of frequencies and percentages. RESULTS: A total of 94 hysterectomies for benign gynaecological conditions were done during the study period. Nine (~10%) vaginal hysterectomies were done. All the vaginal hysterectomies performed were for uterovaginal prolapse by consultants. However, 45 (53%) of the abdominal hysterectomies were performed by consultants and 40 (47%) by residents. CONCLUSION: This study suggests that residents' exposure and training on the act of vaginal hysterectomy is inadequate. This has potential implications on future gynaecologist proficiency to perform this method of surgery that has documented advantages and better outcome for patients. WAJM 2009; 28(5): 323-326.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Underutilization of Vaginal Hysterectomy and its Impact on Residency Training

Ocheke¹,

Cc²,

Musa³

2010

West African Journal of Medicine

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“…Twenty-five of the women were nulliparous. Gyna ecologists practicing in developing countries, in particular Nigeria are usually reluctant to perform hysterectomy in young nulliparous females except in advanced malignant diseases, unsuccessful myomectomy for uterine fibroids and uterine rupture which is a medical emergency (9,13). In developed countries, parity is not a limiting factor (1,2,10).…”

Section: Discussionmentioning

confidence: 99%

“…22 incidental leiomyomata were also found in specimens removed for other reasons. Many studies in Nigeria and other parts of Africa have documented fibroid as the leading indication for hysterectomy in Black African Women (8)(9)(10)(11)13).…”

Section: Discussionmentioning

confidence: 99%

Clinico-pathological Assessment of Hysterectomies in Zaria

Adesiyun

Agunbiade

et al. 2009

ELECTRON J GEN MED

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Aim: To assess and compare accuracy of the clinical indications and histopathological diagnoses from hysterectomy specimens in Zaria. Methods The clinical indications comprised non-neoplastic-47 (14.8%) and neoplastic-226 (71.3%) causes. The commonest benign neoplastic indication was uterine fibroid 196 (61.8%). Malignant neoplastic indication included cervical cancer 12 (3.8%) and endometrial cancer 6 (1.9%). Cervical intraepithelial neoplasia (CIN), a preneoplastic lesion accounted for 44 (13.9%). Histopathological diagnosis of leiomyoma was made in 218 (68.8%), cervical cancer -20 (6.3%) and . Incidental pathologies seen included chronic patients were at variance with histological diagnosis. Conclusion:The clinical indication for hysterectomy and histopathological outcome are comparable in over 90% of cases. The commonest indication and histological finding in our setting is leiomyoma.

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Underexposure of Residents in Training in the Art of Vaginal Hysterectomy in Nigeria

Tc¹,

Ikeako²,

Ezenyeaku³

2014

AJCMR

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Worldwide, vaginal route is the gynaecologist's route of surgery. However, abdominal route is the favoured route of hysterectomy in Nigeria inspite of the advantages of vaginal route. This descriptive review is to awaken interest in the teaching and surgical exposure of residents in obstetrics and gynaecology in the field of vaginal surgeries. The ratio of vaginal hysterectomy to abdominal hysterectomy in Nigeria ranges from 1:4 to 1:9. The frequency of vaginal hysterectomy in centres in Nigeria ranges from 10-23%. These rates are lower than the figures quoted from the United States (25%), France (50%), Australia (40-50%) and Saudi Arabia (28%). Vaginal hysterectomy is under-utilized in Nigeria. Most centres hardly do up to five vaginal hysterectomies in a year. Residents in training hardly perform vaginal hysterectomy and may not have watched or assisted in up to ten vaginal hysterectomies before the residency programme is completed. This is completely inadequate for acquisition of proficiency. There is inadequacy and under exposure of residents in the art of vaginal surgeries in Nigeria. There is need for workshops, training and retraining of residents in the field of vaginal surgeries to meet these challenges. This would ensure production of quality gynaecologists with skills and proficiency in vaginal surgery.

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Audit of hysterectomies in a group of private hospitals in Kaduna City, northern Nigeria

Cited by 4 publications

References 0 publications

Underutilization of Vaginal Hysterectomy and its Impact on Residency Training

Underutilization of Vaginal Hysterectomy and its Impact on Residency Training

Clinico-pathological Assessment of Hysterectomies in Zaria

Underexposure of Residents in Training in the Art of Vaginal Hysterectomy in Nigeria

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