A 2 year histopathological audit for non-oncological hysterectomies in a tertiary care hospital


  • Salma Bhat Department of Pathology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Nazia Bhat Department of Pathology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Isma Niyaz Department of Pathology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Rohi Wani Department of Pathology, Government Medical College, Srinagar, Jammu and Kashmir, India




Audit, Histopathologic, Hysterectomies


Background: Hysterectomy is the most common gynecological surgery in the world and is considered to be the most definitive treatment option for various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens

Methods: This was a retrospective audit. The pre-operative diagnosis and histopathologic data of all consecutive specimens of hysterectomies were collected and analysed. Those with confirmed malignancy before operation were excluded. All elective as well as emergency hysterectomies (including obstetric hysterectomies) were analyzed. Preoperative indications were compared with the final histopathological report.

Results: Most common indication for hysterectomy was symptomatic fibroid uterus followed by utero-vaginal prolapse and obstetric causes. Overall, there was no pathology identified in approximately 50% of all hysterectomies received in our department.

Conclusions: Proper audit and review can help in improving the quality of health care in our country. The results of our study may help to reduce inappropriate indications for hysterectomy.


Gupta G, Kotasthane DS, Kotasthane VD. Hysterectomy: a clinico-pathological correlation of 500 cases. Int J Gynecol Obstet. 2009;14(1):1-5

Magon N, Chahuan M. Editorial. Subtotal Hysterectomy: has it come a full circle?. Int J Clin Cases Investigations. 2012;4:1-4.

Broder MS, Kanouse DE, Mittman BS, Bernstein SJ. The appropriateness of recommendations for hysterectomy. Obstet Gynecol. 2000;95(2):199-205.

Bhattacharya S, Middleton LJ, Tsourapas A, Lee AJ, Champaneria R, Daniels JP, et al. Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: A systematic review of clinical effectiveness and cost-effectiveness analysis. Health Technol Assess. 2011;15:1-252.

Bala R, Devi KP, Singh CM. Trend of hysterectomy: A retrospective analysis in Regional Institute of Medical Sciences (RIMS). J Med Soc. 2015;29:4-7.

Aksu F, Gezer A, Oral E. Seventeen-year review of hysterectomy procedures in a university clinic in Istanbul 1985-2001. Arch Gynecol Obstet. 2004;270(4):217-22.

Pandey D, Sehgal K, Saxena A, Hebbar S, Nambiar J, Bhat RG. An audit of indications, complications, and justification of hysterectomies at a teaching hospital in India. Int J Reprod Med. 2014;2014.

Leung PL, Tsang SW, Yuen PM. An audit on hysterectomy for benign diseases in public hospitals in Hong Kong. Hong Kong Med J. 2007;13(3):187-93.

Sucheta KL, Manangi M, Madhu KP, Arun BJ, Nagaraj N. Hysterectomy: clinical profile, indications and postoperative complications. Int J Reprod Contracept Obstet Gynecol. 2016;5:2093-6.

Shaikh TA, Memon F, Memon Z. Hysterectomies; an audit at a tertiary care hospital. Professional Med J. 2011;18(1).

Juneja SK, Tandon P, Mohan B, Kaushal S. A change in the management of intractable obstetrical hemorrhage over 15 years in a tertiary care center. Int J Appl Basic Med Res. 2014;4(Suppl 1):S17-S19.

Bodelon C, Bernabe-Ortiz A, Schiff MA, Reed SD. Factors associated with peripartum hysterectomy. Obstet Gynecol. 2009;114(1):115-23.

Nwobodo E, Nnadi D. Emergency obstetric hysterectomy in a tertiary hospital in sokoto, Nigeria. Ann Med Health Sci Res. 2012;2(1):37-40.

Shirodker SD, Pandey A, Yadav S. Emergency obstetric hysterectomy: review at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5:3811-4.

Tiwana KK, Nibhoria S, Monga T, Phutela R. Histopathological audit of 373 nononcological hysterectomies in a teaching hospital. Pathol Res Int. 2014;2014.






Original Research Articles