The Epidemiology Profile of Hysterectomy in Northern Zimbabwean Women

Abstract

Hysterectomy is a procedure commonly performed to treat uterine and cervical disorders. It is a common procedure in developing countries, others listing it as the most common gynecological procedure in developed countries. The aim of the study is to determine the epidemiology profile of hysterectomy in Northern Zimbabwean women. It can either be classified according to the procedure used to perform the hysterectomy; which could be a total abdominal hysterectomy, uterus only, subtotal hysterectomy, total abdominal hysterectomy plus salphingo-oophorectomy, total abdominal hysterectomy plus bisalphingo-oophorectomy and radical hysterectomy. It can be vaginally, abdominally or laparoscopy assisted. Laparoscopy assisted vaginal hysterectomy is less common as the procedure is semi-automated. The aim of the study was to determine the prevalence of hysterectomy among the women in northern Zimbabwe, identifying patterns of occurrences and distribution of hysterectomy and determining possible indicators of hysterectomy. Parirenyatwa Group of Hospitals undertakes Histology laboratory testing of samples from hospitals in Northern Zimbabwe as the referral laboratory. A retrospective study was conducted using the census sampling method to determine the epidemiology profile of hysterectomy. The study collected 350 reports from 2019 that indicated to have been from hysterectomy and therefore the estimated prevalence rate of hysterectomy was 9.81%. The study looked at the reports of specimens brought in due to the performance of hysterectomy. The inclusion criteria of a report was a complete histology report from the Pathologist from specimens processed and microscopy slides prepared by the Scientist. Exclusion criteria was an incomplete report. Leiomyomata, post-partum hemorrhaging and chronic pelvic pain were the leading possible indicators of hysterectomy. The procedure was most commonly performed on women between the ages of 41-50 years. The total abdominal hysterectomy was 59.81% performed most of the time with most reports from Parirenyatwa Group of Hospitals and then Mutare Provincial Hospital. Delimitations was the low resource costing of the study and the automated collection of the data. The limitations were clerical errors, lack of patient data such as clinical history and lack of history or socio-economic demographics collected by the laboratory form. There is need for better data management and increase in the variation of data to collect such as clinical history, parity, marital status, income setting and other factors. Further studies can be done to give a holistic picture of the epidemiology profile of hysterectomy in Zimbabwe. There is need for an awareness campaign on hysterectomy as it is a growing common procedure among women in developing countries. Case studies would give intrinsic details unavailable in reports. Better Sexual and reproductive health information should be availed on indicators of hysterectomy according to their prevalence in different age groups.