Clinico–pathological study of hysterectomy in benign lesions: a study of 379 hysterectomies

Abstract

Background: Uterus is a very vital reproductive organ and is subjected to many benign and malignant diseases. Hysterectomy is one of the most frequently performed procedures all over the world. Aims and Objectives of the work was to study the clinical benign indications of hysterectomy specimens and to correlate the findings with the histopathological reports.Methods: A prospective and randomized study was performed in 379 cases of elective hysterectomies for benign lesions.Results: Abdominal hysterectomy was performed in 64.6% cases while vaginal hysterectomy accounted for 35.3% cases. The mean age for hysterectomy was 45 years with a range from 14 to 78 years. Patients mostly presented with menstrual irregularities (34.3%) followed by prolapse uterus (30%). The principle indication of elective hysterectomy was leiomyoma and was present in 197(51.9%) patients, followed by prolapse uterus in 134 (35.3%) and dysfunctional uterine bleeding (DUB) in 26 (6.8%) patients. Maximum numbers of cases of leiomyoma, uterine prolapse and DUB were found in age group of 41-50 yrs.Conclusions: The number of abdominal hysterectomy was more than vaginal hysterectomy. Most common presenting feature was menstrual related symptom followed by prolapsed. The main indication for elective hysterectomy was leiomyoma, prolapsed and DUB.

A clinical study of elective hysterectomies for benign lesions

“…These results are in accordance with the study done by Fatehpuriya et al and Sreedhar et al 9,19 The most common finding of ovary, on the basis of histopathological reports, were physiological ovarian cysts 58(48.3%), normal in 56 (46.7%) and pathological findings were reported in 6(5%).…”

“…In the present study, incidence of hysterectomies done amongst the total number of gynecological admissions was 35.3% (120/340) of which the incidence of abdominal hysterectomy was 21.4% and vaginal hysterectomy was 3.8%.This incidence was comparable with Fatehpuriya et al study and more than Parveenet al study because of non-availability of newer techniques in our hospital, hysterectomy continue to be the main treatment option for benign gynecological diseases. 9,10 The commonest surgical approach was abdominal hysterectomy (60.8%) followed by vaginal hysterectomy (39.2%) ratio being 1.5 which is similar to other studies. 11,12 The peak age incidence of patients was 41-50 years, while the mean parity was 4, such figures are comparable to those reported in previous studies.…”

“…The most common presenting features were menstrual related symptoms (40.8%) followed by prolapse (38.3%) which was similar in sequence to Qamar-ur-nisa et al 15 The principle indications for elective hysterectomy group were leiomyoma (44.2%) which was somewhat similar TABLEincidence reported by earlier studies. 9,15 The second common complaint reported was prolapse 47 cases, all vaginal hysterectomies were done for prolapse which was associated in one case with fibroid uterus which is comparable to study done by Ajmera et al 16 As most of the cases of leiomyoma in the present study were multipara indicates that high parity has a definite relationship with uterine pathology.…”

“…These findings are correlated well with the previous studies. 9,12,14,17 Vaginal route had less chance of post-operative complications as it is less invasive surgery with comparatively lesser disruption of tissue i.e. it avoids the dissection of skin, muscle, sheath, big portion of peritoneum and it also avoids handling of gut, similar to study conducted by AL-Kadri et al 18 As all hysterectomies were done post-menstrualy hence endometrium in maximum cases were in proliferative phase, fibroid and DUB being hyper-estrogenism and anovulatory would have proliferative endometrium.…”

A Clinico-Pathological Study on Hysterectomy in a Tertiary Care Hospital

“…6 But in spite of large number of potential alternatives to hysterectomy for benign diseases, hysterectomy rates have remained relatively stable because it is associated with higher rates of patient satisfaction than other methods. 7,8 Types of Hysterectomies include Abdominal hysterectomy (AH), Vaginal Hysterectomy (VH), Laparoscopic hysterectomy and Robotic hysterectomies. These procedures have undergone important changes recently.…”