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

Abstract

Background: Hysterectomy is an effective treatment for a wide range of gynaecological diseases, both benign and malignant. There must be a pe­riodic audit for the appropriate indication of the surgery and its complica­tion rate. Histopathological analysis is mandatory for definitive diagnosis and further management. This study aims to review the clinical profile, indications of hysterectomy and to assess the correlation between the clinical diagnosis and histopathological report.
 Methods: A retrospective study of all the patients undergoing abdominal hysterectomy was conducted in the Department of Obstetrics and Gyne­cology, Chitwan Medical College Teaching Hospital, Nepal from January to December 2018. Demographic and clinical informations were retrieved from the medical record section. Datas were entered in the pre-designed proforma. Statistical analysis was done in terms of percentages, standard deviation, correlation and mean.
 Results: During the study period, 111 patients underwent abdominal hys­terectomy. The mean age of the patients was 46 years. The mean dura­tion of hospital stay was 8.7 days. Abnormal menstrual flow and pain ab­domen were the commonest presenting symptoms. The most common preoperative diagnosis was fibroid followed by ovarian tumor. Leiomyoma was the commonest lesion on histopathological examination. The correla­tion between clinical diagnosis and histopathology was 96.07% for fibroid, 80.95% for ovarian tumor, 66.67% for adenomyosis and 38.46% for DUB.
 Conclusions: Fibroid uterus and ovarian mass are the common indications for abdominal hysterectomy. Histopathology is mandatory for confirming the diagnosis, proper counseling and holistic management of the patient.

Clinical profile of patients undergoing abdominal hysterectomy at a medical college in Nepal

“…These results were comparable with the results obtained by Shrestha S et al 11 Significant correlation was between clinical diagnosis and histopathology was also shown in the study done by Acharya S et al and Tiwana KK et al 10,17 Twenty seven patients (26.7%) had various complications following hysterectomy in our series. Almost comparable complications were found in the study done by Shrestha et al 11 Surgical site infection needing resuturing was seen in 10% patients followed by urinary tract infection and chest infection. Wound infection was noted in obese patients and in patients who were diabetic and had anaemia before surgery.…”

“…10 Majority of the patients presented with pain abdomen (49.5%) and menstrual symptoms (38.6%). These were the main complaints noticed in patients in a study done by Acharya S. 10 Similar findings were also noted in a study done by Shrestha S et al 11 The number of hysterectomies performed for fibroid uterus varied between studies done in Nepal and abroad. The most common indication for abdominal hysterectomy in our series was fibroid uterus and it accounted for 51.5% followed by for ovarian tumours (16.8%) and DUB (13.9%).…”