Analytical study of hysterectomies

Shivaji Neelgund, Panchaksharayya Hiremath


Background: Since early 20th century hysterectomy came into widespread use. The incidence of hysterectomy varies from place to place depending upon the clinical and clinician factors. Sometimes there are considerable problems in clinical assessments as the patient’s complaints, the clinical findings and per-operative diagnosis does not correlate with histopathological diagnosis. This is a retrospective study to correlate and evaluate the sensitivity between the indications, demographic features, clinical presentations, per-operative findings and histopathological diagnosis of patients who underwent hysterectomy.

Methods: This study was conducted in the department of obstetrics and gynaecology, in SVMCH and RC, Ariyur, Pondicherry, India. There were 1124 cases of hysterectomies done over a period of five years, from 2011 to 2015. Data was recorded and analyzed from the case record of each patient, which was obtained from the medical record department of the hospital.

Results: During the study period there were 1124 cases of hysterectomies done; out of which total abdominal hysterectomy with bilateral salphingo-oophorectomy were 915 cases 81.4%. Leiomyoma is the dominant histopathological diagnosis in our study 22.4%. Both adenomyosis and leiomyoma was present in 6.4% of the cases. In our study the pre-operative diagnosis, specificity to pathological correlation is 91 to 100%, and for leiomyoma it is 99%.

Conclusions: Hysterectomy is the preferred procedure in the treatment for pelvic pathologies like fibroid, adenomyosis, pelvic inflammatory disease and malignant disorder, and genital prolapse. Majority of the hysterectomy procedures are performed via an abdominal approach.



Hysterectomy, Menorrhagia, Histopathology, Leiomyoma, Adenomyosis

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Maresh MJ, Metcalfe MA, McPherson K, Overton C, Hall V, Hargreaves J, et al. The VALUE national hysterectomy study: description of the patients and their surgery. BJOG. 2002;109:302-12.

Rather GR, Gupta Y, Bharadwaj S. Patterns of lesions in hysterectomy specimens; a prospective study. J K Science. 2013;15(2)63-8.

Singh A, Arora AK. Why hysterectomy rate are lower in India. Indian J Community Med. 2008;33(3):196-7.

John A, Rock MD, Jhon D, Thompson MD. Telinds’s operative gynaecology. 1st Edition Lippincott. Med J; 2003:878-890.

Nousheen F, Iqbal J, Bhatti FA, Sheik S. Hysterectomy the patient perspective. Ann Gynaecol. 2004;10:339-41.

Olsson JH, Ellstrom M, Hahlin M. A randomized prospective trial comparing laparoscopic and abdominal hysterectomy. British Journal of Obstetrics and Gynaecology. 1996;103:345-50.

Dicker RC, Seally MJ, Greenspan JR, Layde PM, Ory HW, Maze JM, et al. Hysterectomy among women of reproductive age trends in United States. JAMA. 1990;248:328-35.

Wood C, Maher P, Hill D, Selwood T. Hysterectomy: a time of change. Med J Aust. 1992;157:651-3.

Abdulla LS. Hysterectomy: a clinic pathological correlation, Bahrain Medical Bulletin. 2006;28(2):1-6.

Sobande AA, Eskander M, Archibong EI, Damole IO. Elective hysterectomy: a clinic pathological review from Abha catchment area of Saudi Arabia. West Afr J Med. 2005;24:31-5.

Jacoby VL1, Autry A, Jacobson G, Domush R, Nakagawa S, Jacoby A. Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol. 2009:114:1041-8.

Isaoğlu U. The evaluation of diagnosis in specimens of hysterectomy. Abant Med J. 2013;2(2):941-943.

Ramachandran TS, Sinha R, Subramanium. Correlation between clinic pathological and ultrasonographic findings. Journal of Clinical Diagnosis and Research. 2011;5(4):734-40.

Huma Z, Naeem A, Shoaib M, Fayyaz S, Arjumand. A clinic pathological review of elective hysterectomies in Sir Ganga Ram hospital. Pak J Med Health Sci. 2012;6(4):970-2.

Jha R, Pant AD, Jha A, Adhikari RC, Syami G. The histopathological analysis of hysterectomy specimens. J Nepal Med Assoc. 2006;45(163):283-90.

Chryssipolous A, Loghi SC. Indications and results of total hysterectomy. Int Surg. 1986;71(3):188-94.

Gaym A. Elective hysterectomy at Tikur Anbessa teaching hospital, Addis Ababa. Ethiop Med J. 2002;40(3):217-26.

Bukar M, Audu B, Yahaya UR. Hysterectomy for benign gynaecological conditions at Gombe, North Eastern Nigerian. Nig Med J. 2010;35-8.

Ajmera SK, Mettler L, Jonat W. Operative spectrum of hysterectomy in a German university hospital. J Obstet Gynecol India. 2006;56(1):59-63.

Aksu F, Gezerand A, Oral E. Seventeen-year review of hysterectomy procedures in a university clinic in Istanbul (1985-2001). Archives of Gynecology and Obstetrics. 2004;(4):217-22.

Khaniki M, Shojaie M, Tarafdari AM. Histopathological study of hysterectomy operations in a University clinic in Tehran from 2005 to 2009. J Fam Reprod Health. 2011;5(2):51-5.

Shergill SK, Shergill HK, Gupta M, Kaur S. A clinic pathological study on hysterectomies. J Indian Med Assoc. 2002;100(4):238-9.

Neena Y, Honey B. Clinico-pathological correlation of hysterectomy specimens for abnormal uterine bleeding in rural area. J Evol Med Dent Sci. 2013;39(2):7506-12.

Gupta G, Kotasthane DS, Kotasthane VD. Hysterectomy: a clinico-pathological correlation of 500 cases. The Internet Journal of Gynaecology and Obstetrics. 2010;14(1):1-5.

Khan R, Sultana H. How does histopathology correlate with clinical and operative findings in abdominal hysterectomy? JAFMC Bangladesh. 2010;6(2):17-20.

Dinçgez B, Coşkun Eİ, Ayanoğlu YT. Kliniğimizdegerçekleştirilen histerektomi olgularının değerlendirilmesi. Şişli Etfal Hastanesi Tıp Bülteni. 2011;45:35-8.

Cameron IT. Laparoscopy and laparoscopic surgical techniques in Whitfield CR, ed. Drewhurst Textbook Obstetrics and Gynaecology for Postgraduate Students, 6th edn. London: Blackwell Scientific Publication; 1999:505-22.

Clarke A, Black N, Rowe P, Mott S, Howle K. Indications for and the outcome of total abdominal hysterectomy for benign disease: prospective cohort study. Br J Obstet Gynaecol. 1995;102:611-20.

Tan XJ, Lang JH, Shen K, Liu ZF, Sun DW, Leng JH, et al. Operative approaches, indications, and medical economics evaluation of4180 cases of hysterectomy. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003;25(4):406-9.

Jeffcoate’s Principles of Gynaecology 7th international edition Kumar P, Narendra Malhotra; 2014:490.

Bide P, Bhide A. Uterine adenomyosis. J Obstet Gynecol. 1994;44(4):612-5.

Sarfraz T, Tariq H. Histopathological findings in menorrhagia: a study of 100 hysterectomy Specimens. Pak J Pathol. 2005;16(3):83-5.

Praveen S, Tayyab SH. Clinic pathological review of elective abdominal hysterectomy. Journal of Surgery Pakistan. 2008;13(1):26-9.

Jamal S, Braai S. A clinic histopathological analysis of 260 Hysterectomies Pakistan. J Pathol. 2001;12(2):11-4.

Talukder SI, Haque MA, Huq MH, Alam MO, Roushan A, Noor Z, et al. Histopathological analysis of hysterectomy specimens. Mymensingh Med J. 2007;16(1):81-4.

Ranabhat SK, Shrestha R, Tiwari M, Sinha DP, Subedee LR. A retrospective histopathological study of hysterectomy with or without salpingo-oophorectomy specimens. JCMC. 2010;1(1):26-9.

Ojeda VJ. The pathology of hysterectomy specimens. Z Med J. 1979;89:169-71.

Lee NC, Dicker RC, Rubin G, Oray HW. Confirmation of the preoperative diagnosis for hysterectomy. Am J Obstet Gynecol. 1984;150(3):283-7.