DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212185

A clinical study of elective hysterectomies for benign lesions

Mamta Meena, Urvashi ., C. P. Kachawaha, Dharmendra Singh Fatehpuriya

Abstract


Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.

Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.

Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.

Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women.


Keywords


Abdominal, Benign, Histopathology, Hysterectomy, Leiomyoma, Vaginal

Full Text:

PDF

References


Kjerulff KH, Erickson BA, Langenberg PW. Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992. American J Public Health. 1996;86(2):195-9.

Dwyer N, Hutton J, Stirrat GM. Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia. BJOG: An International Journal of Obstetrics & Gynaecol. 1993;100(3):237-43.

Hysterectomies rate for benign conditions in USA, 1994-2003. Obstet Gynecol. 200;107(6):1278-83.

Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R. Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials. Bmj. 2005;330(7506):1478.

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

Gupta S, Manyonda I. Hysterectomy for benign gynaecological disease. Current Obstetrics & Gynaecol. 2006;16(3):147-53.

Sobande AA, Eskander M, Archibong EI, Damole IO. Elective hysterectomy: A clinicopathogical review from Abha catchment area of Saudi Arabia. West African J Medic. 2005;24(1):31-5.

Kovac SR. Clinical opinion: guidelines for hysterectomy. American journal of obstetrics and Gynecol. 2004;191(2):635-40.

Fatehpuriya DS, Verma L, Sharma S. Clinico–pathological study of hysterectomy in benign lesions: a study of 379 hysterectomies. International Journal of Reproduction, Contraceptive, Obstetrics and Gynecol. 2017;6:934-8.

Perveen S, Tayyab S. A clinicopathological review of elective abdominal hysterectomy. Journal of Surgery Pakistan (International). 2008;13(1):26-9.

Baral R, Sherpa P, Gautam D. Histopathological analysis of hysterectomy specimens: one year study. Journal of Pathology of Nepal. 2017;7(1):1084-6.

Patel AS, Shah KJ. Histo pathological analysis of hysterectomy specimens in tertiary care center: two year study. Trop J Path Micro. 2018;4(1):34-9.

Suad MO. Zaid, Mazen ABT. Middle East Journal Of Internal Medic. 2017;10(1):17-24.

Patil T, Kulkarni MA, Anand AS, Punyashetty KB. Histomorphological study of lesions of corpus uteri in hysterectomy specimens: a tertiary care centre study. Trop J Path Micro. 2019;5(9):684-91.

Shaikh TA, Memon F, Memon Z. Hysterectomies; An Audit At A Tertiary Care Hospital. Professional Medical J. 2011;18(1).

Sachin AK, Mettler L, Jonat W. Operative spectrum of hysterectomy in a German university hospital. J Obstetrics And Gynecology India. 2006;56(1):59-63.

Subrata P, Srabani C, Anuradha S, Prakash PJ, Kingshuk B, Mrinal S. A retrospective clinico-pathological study of hysterectomy cases in a tertiary care hospital in India–a review of 950 cases. Bangladesh Journal of Medical Science. 2018;17(1):88-92.

Al-Kadri HM, Al-Turki AH, Mo AM. Short and long term complications of abdominal and vaginal hysterectomy for. Saudi Med J. 2002;23(7):806-10.

Sreedhar VV, Jyothi C, Sailaja V, Paul MC, Sireesha O, Vani T, Kumar KM. Histopathological Spectrum of Lesions of Hysterectomy Specimens–A Study of 200 Cases. Saudi J Pathol & Microbiol. 2016;1(2):54-9.