An audit of hysterectomies: indications, complications and clinico pathological analysis of hysterectomy specimens in a tertiary care center

Abstract

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It is an effective treatment option for many gynecological conditions. Aim and objective of the study was to analyse the indications, complications of hysterectomies and to see whether preoperative clinical diagnosis was confirmed by histopathology.Methods: Authors present a retrospective study of 198 hysterectomised cases over a period of one year from January 2016 to December 2016. The data regarding patients age, parity, indication for hysterectomy, type of hysterectomy, complications during and after surgery and final histopathological diagnosis were collected from the records and analysed.Results: A total of 198 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 32 years to 75 years. Most common age group was 41-50 years. Majority were done through abdominal route 162 cases (81%). Most common indication was abnormal uterine bleeding 56 (28%) and fibroid 41 (21%). One case of accidental bladder injury was noted. Most common postoperative complication was fever (23%). Most common histopathological lesion was fibroid 101 (51%). In three cases preoperative clinical diagnosis did not correlate with final histopathological diagnosis.Conclusions: As any surgical procedure, hysterectomy is also associated with risk of complications. Hence the indication should be carefully evaluated. Reporting of all hysterectomies should be made mandatory and audit results should be used for improvement of quality of health service. Newer and less invasive treatment options should be offered to women with benign pathologies. This will further reduce the incidence of hysterectomy.