DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183782

Retrospective analysis of elective hysterectomy cases in a tertiary care centre

Divya R. Prasad, Neelima V. Nair

Abstract


Background: Often hysterectomy remains the only option available in many gynaecological conditions, though it is resented by most women. This study aims to analyse the cases of hysterectomy performed in a tertiary care centre in India, with a view to modify and improve health care provided to women.

Methods: A retrospective analysis of 500 cases of elective hysterectomy in Sree Gokulam Medical College and Research Foundation from January 2016 to December 2017 was done from hospital records. The observations according to age, indications of hysterectomy, route of hysterectomy and preservation of ovaries were statistically analysed.

Results: 35.2% (176 cases) were between 45 and 50 years. Mean age was 48±2 years. 90.4% (452 cases) were done in women above 40 years of age. The commonest indication for hysterectomy was symptomatic fibroid uterus 59.4% (297 cases). 81.8% (409 cases) women underwent abdominal hysterectomy while 18.2 % (91 cases) women underwent vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy. 84.6% (77 of 91 cases) of vaginal hysterectomy was done for prolapse uterus. Preservation of one or both ovaries was done in 47.2% (236 cases).

Conclusions: Hysterectomy is usually done after the age of 40 years with the mean age being 48±2 years. Symptomatic fibroid uterus was the most common indication. The rates of vaginal hysterectomy were lower for indications other than prolapse uterus. Ovaries were preserved in several cases.


Keywords


Hysterectomy, Indication, Preservation of ovaries, Route

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References


Bala R, Devi Pratima K, Singh CM. Trend of hysterectomy. A retrospective analysis in RIMS, Imphal. Int J Gynaecol Obstet India. 2013;29(1): 4-7.

Desai S, Sinha T, Mahal A. Prevalence of hysterectomy among rural and urban women with and without health insurance in Gujarat, India. Reprod Health Matters. 2011 Jan 1;19(37):42-51.

Rajeshwari BV, Hishikar V. Views and reviews of hysterectomy: a retrospective study of 260 cases over a period of 1 year. Bombay Hospital J. 2008;50(1):59.

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.

Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007 Nov 1;110(5):1091-5.

Lethaby A, Shepperd S, Cooke I, Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. The Cochrane Database System Rev. 2000(2):CD000329.

Gupta JK, Sinha AS, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev. 2006;5(1):ID CD 005073, 2006.

McPherson K, Herbert A, Judge A, Clarke A, Bridgman S, Maresh M et al. Psychosexual health 5 years after hysterectomy: population‐based comparison with endometrial ablation for dysfunctional uterine bleeding. Health Expectations. 2005 Sep;8(3):234-43.

Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R. Surgical approach to hysterectomy for benign gynaecological disease (Cochrane Review). In: Cochrane Library, Oxford: Update Software. 2006(2).

Meikle SF, Nugent EW, Orleans M. Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Int J Gynecol Obstet. 1997 Feb 1;57(2):242.

Summitt JR, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol. 1992 Dec;80(6):895-901.

ACOG Committee Opinion. Number 311, April 2005. Appropriate use of laparoscopically assisted vaginal hysterectomy. Obstet Gynecol. 2005 Apr;105(4):929-30.

Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M et al. evaluate hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health technology assessment (Winchester, England). 2004 Jun;8(26):1-54.

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: Int J Obstet Gynaecol. 2002 Mar;109(3):302-12.