Hysterectomy for benign conditions in a university hospital in Saudi Arabia

Abstract

BACKGROUND AND OBJECTIVEHysterectomy is a common surgical procedure among women with a lifetime prevalence of 10%. The indications and complications of this procedure have not been previously reported from a teaching institution in Saudi Arabia. We examined the indications for hysterectomy and the surgical morbidity for women undergoing hysterectomy at a university hospital in Saudi Arabia.PATIENTS AND METHODSWe reviewed the records of women who underwent hysterectomies for benign gynecological conditions between January 1990 and December 2002, at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, comparing patient characteristics, indications for hysterectomy and the rate of complications in women undergoing abdominal hysterectomy (AH) versus vaginal hysterectomy (VH).RESULTSOf 251 women, 199 (79%) underwent AH and 52 (21%) underwent VH. An estimated blood loss of ≥500 mL occurred in 104 patients (52.3%) in the AH group and in 20 patients (38.5%) in the VH group (difference not statistically significant). The most common indications for hysterectomy were uterine fibroids (n=107, 41.6%) and dysfunctional uterine bleeding (n=68, 27.1%). The most common indication for VH was uterine prolapse (n=45, 86.5%). The overall complication rates were 33.5%, 15.4% and 30.4% in women who underwent AH, VH and both, respectively. Intraoperative and postoperative complications occurred in 24 (9.7%) patients in the AH group and in 51 patients in the VH group (20.3%). Postoperative infection occurred in 42/199 (21.6%) in the AH group and 5/52 (9.6%) in the VH group (difference not statistically significant).CONCLUSIONSWe describe a large series of hysterectomies, which provides information for surgeons on the expected rate of complications following hysterectomy for benign conditions. We found that the rate of complications was not significantly higher than other centers internationally.

A Retrospective Review: Vaginal versus Abdominal Hysterectomy for Benign Gynecological Diseases in a Tertiary Canter

“…In contrast to other studies from Germany [9], France [10], and Finland [11] more hysterectomies are performed vaginally than abdominally. Previous studies [6] [8] [9] reported that vaginal approach mainly used in patients with uterine prolapse that is similar to our results.…”

Gynecological diseases in rural India: A critical appraisal of indications and route of surgery along with histopathology correlation of 922 women undergoing major gynecological surgery

“…In review of literature, leiomyoma uterus is the most common indication for hysterectomy worldwide. [78910111213] However, our observation of POP being the most common indication for benign gynecological surgery could be due to higher number of unsupervised home conducted vaginal births with tendency for premature bearing down during labor in rural and tribal populations. Younger women in third decade of life were offered conservative approach of Fothergill's operation and Purandare's cervicopexy, whereas definite surgery, that is, VH with pelvic floor repair was done in elderly women.…”

Hysterectomy: still a treatment of choice for pelvic pathologies in rural India

“…In review of literature also, fibroid uterus is reported as the most common indication for hysterectomy worldwide. 16,[18][19][20][21] However, there has been controversy regarding indications for hysterectomy for benign gynecological diseases in Indian subcontinent. 22 Of total, only 6% surgeries were done for premalignant cervical lesions in the study which conclude that rural women with cervical malignancy usually present late due to lack of awareness, non availability of adequate screening tests and pathologists.…”