Comparative study on specimen of Hysterectomy (original) (raw)
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A Critical Review of 100 Cases of Hysterectomy: A Prospective Study in a Tertiary Care Centre
Scholars International Journal of Obstetrics and Gynecology, 2021
Background: Hysterectomy is the removal of the uterus with or without cervix. When this is done through an abdominal incision it is called abdominal hysterectomy. When the approach is through vaginal vault it is called vaginal hysterectomy. Hysterectomy is a major gynecological operative procedure commonly indicated for women with dysfunctional bleeding, uterine leiomyoma, prolapse, endometriosis & adenomyosis, pelvic pain, premalignant conditions and cancer. Objective: The purpose of the study was to find out the common indications of hysterectomy. Methods: The Study was conducted in the department of obstetrics and gynaecology of Dhaka Medical College Hospital, Dhaka, Bangladesh to find out the common indications of hysterectomy. 100 cases were randomly selected for the study whose common indication of hysterectomy. Clinical examination and evaluation were done from October 2004 to February 2005. Other necessary investigations were done if clinically indicated and to prepare the patient for anesthesia. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Majority of cases who underwent hysterectomy were 31-40 years (52%) of age. Out of 100 cases most of patients (70%) underwent abdominal hysterectomy and only 30 (30%) cases underwent vaginal hysterectomy. Out of 33 cases, clinically diagnosed as leiomyoma of the uterus histopathology revealed leiomyoma in 24 cases. In uncomplicated abdominal and vaginal hysterectomy, the duration of surgery was almost same, vaginal hysterectomies needs slightly longer time. Average hospital stay after operation was same. Conclusion: For a woman with severe pelvic pain or heavy irregular periods a hysterectomy often means relief from troublesome symptoms. Hysterectomy is offered as a definitive treatment and is associated with high level of satisfaction.
An Observational Study on the Age Group of Women Undergoing Hysterectomy in Eastern Part of India
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Hysterectomy is the most common non-pregnancy related major surgery performed on women. Hysterectomy is usually performed by abdominal, vaginal or laparoscopic route. The lifetime risk of hysterectomy ranges from 20%-35%. Hysterectomy is done generally in late perimenopausal and postmenopausal age groups. Hysterectomy is done for various indications, like menorrhagia, uterine prolapse, postmenopausal bleeding etc. These indications in turn may be due to pathologies like fibroid uterus, adenomyosis, endometrial polyp, endometrial hyperplasia or even endometrial cancer. Pathologies are different depending upon the age. METHODS In this study 100 women undergoing abdominal and vaginal hysterectomy in Calcutta National Medical College and Hospital, Kolkata were grouped into different age groups and their percentages were calculated. Women undergoing caesarean hysterectomies and cancer surgeries were excluded. RESULTS We found that 43 patients were of 41-45 years of age which is significantly higher than other age groups. Other studies except a few had similar results. The greater percentage of hysterectomy was by abdominal route (75%), rest were done by vaginal route (25%). Indications also dictate the route of hysterectomy. Vaginal route was opted for the uterovaginal prolapse cases. Only 2 cases of non-descent vaginal hysterectomies were performed. CONCLUSIONS Hysterectomies in earlier than 40 years should be without oophorectomies because of ill effects of loss of estrogen. But keeping behind a potential organ for cysts and cancer is risky as well. So, a risk benefit balance has to be considered. Since perimenopausal age group came out to be the commonest one undergoing hysterectomy, postmenopausal symptoms and its effects remains a matter of concern which needs close follow-up and necessary management.
Retrospective Analysis of Hysterectomy Cases in a Tertiary Care Institute, JNIMS
Journal of South Asian Federation of Obstetrics and Gynaecology, 2021
Aim: To study the indications and clinical profile of patients undergoing hysterectomy in Jawaharlal Nehru Institute of Medical Sciences (JNIMS). Materials and methods: A chart review of 132 hysterectomy cases in JNIMS, from January 2016 to January 2017, was done. Peripartum hysterectomy was excluded. The data regarding age, parity, indications of hysterectomy, length of hospital stay (LOHS), and additional surgical procedures were collected and analyzed. Results: Age distribution ranged from 34 to 73 years. The most common age-group was 41 to 50 years (57 patients, 43.18%), and multiparas (>2 parity) had maximal rate (68 patients, 51.52%) of hysterectomies. The most common indication for hysterectomy was abnormal uterine bleeding (AUB) (56 patients, 4242%). The abdominal route (75.76%) was more common than the vaginal route (23.48%) and minimal access surgery (MAS) (0.76%). Eighty-seven patients (65.91%) underwent bilateral salpingo-oophorectomy. The most noted frequency of hospital stay was 4 days (29 patients, 21.97%). Eleven appendectomies and one cholecystectomy were done as an additional surgical procedure. Conclusion: Nondescent vaginal hysterectomy (NDVH) is an established safe surgical procedure but such route is lesser used. The reason may be due to less exposure to such a procedure. Additional surgical procedure is an advantage in the abdominal route, but studies of the plausible risks that may be associated with such procedures are also lacking. The impact of preservation of the ovary is also a lesser-explored area. Hysterectomy seems to be the first option in treatment where resources are limited. It is time to review our approach to benign conditions before considering surgery as the first option. Clinical significance: Symptomatic relief is palpable by hysterectomy, but lack of studies involving the impact of hysterectomy, for example, psychological, social, economical, etc., is a cause of concern. More prospective data comparing indications of hysterectomy with its impact may be helpful in streamlining absolute indications, and patients may be benefitted from the adverse effects of surgical interventions.
Pakistan Journal of Medical and Health Sciences
Background: Hysterectomy is one of the most common gynecological surgeries regardless of the surgeon’s approach. Purpose: This study was conducted to compare three hysterectomy techniques, viz abdominal, vaginal and laparoscopic hysterectomy, in terms of their effectiveness and low post-op complications. Methods: The study's cohort included 631 women who underwent benign hysterectomies between 2018 and 2022 in tertiary care hospitals in three areas of Pakistan. The patients in Groups A, B, and C comprised 277, 43 and 311 patients, who were surgically operated by LHs, VHs, and AHs, respectively. Findings: Most of the patients with BH were of age 39-50 years and multiparous with an average weight of 71.4+15 Kg. The major (p<0.05) underlying medical conditions were endometriosis, followed by uterine bleeding, fibroids, pelvic prolapse, adenomyosis and gynecological cancer having an incidence of 44.05, 36.45, 11.88, 5.38, 1.26 and 0.95%, respectively. The AH and VH had the highes...
Hysterectomy: retrospective analysis of 476 cases
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Diseases of the female genital tract are commonly encountered in clinical practice. Hysterectomy is the definite treatment for many of the pelvic pathologies. The present study is aimed at analysis of age and types of hysterectomy and evaluation of histopathological reports of the hysterectomy specimens.Methods: A total of 476 consecutive hysterectomy were studied over a period of two years from January 2016 to December 2017.Results: The peak age group of hysterectomy was 41-50 years with 221 (46.43%) cases. The commonest type of hysterectomy was abdominal. The most common endometrial pathology was atrophic endometrium, seen in 131 (27.52%) cases. In myometrium, the most common pathology was leiomyoma in 179 (37.61%) cases. Among cervical lesions, chronic cervicitis was the most common finding, seen in 274 (57.56%) cases.Conclusions: The experience with various types of hysterectomies at our institution has been reviewed. A wide spectrum of lesions were observed when his...
Pakistan Journal of Medical and Health Sciences, 2022
Introduction: Hysterectomy is the most common gynecological procedure. Abdominal approach is preferred for an enlarged uterus especially in cases of fibroids. However, in a small sized uterus, use of vaginal route is supported in well selected cases Objective: Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with the histopathology report for all hysterectomies, performed in a Shalamar Hospital Lahore. Methods: This study was crass sectional and population the obs. And Gyn. Patients of Shalamar Hospital Lahore. This study is a three year retrospective review of 755 cases of hysterectomy either for gynecological or obstetric reasons managed at Shalamar Hospital Lahore from January 2019 to December 2021. Results: Abdominal hysterectomy accounted for 94%, while vaginal hysterectomy accounted for the remaining 6%. In the former category, an 86% had total abdominal hysterectomy while 9% had subtotal hysterectomy. The average duration of hospital stay following surgery was 3-5 days. The average indoor stay was 2-3 days after vaginal hysterectomy and 4-5days after abdominal hysterectomy. There were 4 cases of mortality accounting for a mortality rate of 1.8 %. Post operative morbidity was encountered in 29.4% of the patients. Anaemia was observed in 45.9%,post operative wound infection in 30.1%, pyrexia in 9% patients, chest infection in 6.7%, bladder injury in 3.6%, bowel injury in 1.8% of the patients. Practical Implication: The practical implication of this study is to correctly treat the patients with pre-operative investigation, Complications, and Correlation of Preoperative Diagnosis with the Histopathology Report of Hysterectomies in private hospitals. Conclusions: Hysterectomy is a major gynaecological procedure. Selection of a appropriate route is very important for the safety of the patient and for hospital stay. Like any other surgery, hysterectomy has an inherent set of complications. So clinical selection should be well justified. Like in any major gynecological procedure, a skilled operator can reduce the morbidity and mortality rates. The conservative approaches should be offered before opting for hysterectomy.
A Retrospective Review of Hysterectomies at a Tertiary Care Centre in Central India
Asian Journal of Biomedical and Pharmaceutical Sciences, 2013
Background: Nowadays hysterectomy is one of the most common surgical procedures conducted in Gynaecology all over the world. It has significant associated complications. Objectives: The current study was carried out to find out the indications, route of hysterectomy and associated complications. Methodology: A retrospective study of all the cases of hysterectomy from 1 st March 2010 till 28 th February 2013 done at J.K. Hospital in Bhopal, a teaching hospital in Central India. Results: A total of 230 hysterectomies were done during the study period. Out of this 161 were vaginal hysterectomies while the remaining was abdominal. Most of the patients were not booked and from rural areas. The most common age group was 40-50 years of age. Major indications were dysfunctional uterine bleeding, fibroid uterus and prolapsed uterus. Conclusion: Hysterectomies are most commonly done for dysfunctional uterine bleeding in the 40-50 years age group. To reduce complications it is necessary to properly select the cases and do proper pre operative preparation.
IOSR Journals , 2019
Background: The Centres for Disease Control and Prevention reported that the hysterectomy rate in 2000-2004 was 5.4 per 1000women per year. Types of Hysterectomies include Abdominal hysterectomy (AH), Vaginal Hysterectomy (VH), Laparoscopic hysterectomy and Robotic hysterectomies. These procedures have undergone important changes recently. Abdominal hysterectomy is carried out in cases of gynaecological disorders like Abnormal Uterine Bleeding(AUB), Fibroids, endometriosis, and in malignancies. Materials and Methods: In this study, 150 cases of hysterectomy were analysed from April 2016 to August 2017 at RIMS, Kadapa. Results: Fibroid uterus (54.5%) is the most common indication for hysterectomy in abdominal hysterectomy patients. Fibroid uterus (50%) is the most common indication for hysterectomy NDVH patients.
Cureus, 2020
Introduction Hysterectomy is a common surgical procedure in women, and oophorectomy may also be performed with the hysterectomy. The objective of this study was to identify clinical indications and pathological findings in hysterectomies, performed for gynecological causes, in women of reproductive age (15-49 years) and to determine if oophorectomy or ovarian conservation was performed with the hysterectomy as well as the pathological findings in the ovaries. Methods This cross-sectional study was conducted in the department of Pathology at Dow Medical College in Karachi, Pakistan, from September 2017 to December 2018. Data were recorded from the pathology reports of hysterectomy specimens received in the department. Data of hysterectomies performed for gynecological causes in women of reproductive age group were selected and analyzed, using Microsoft Excel (Microsoft, Redmond, Washington) and SPSS version 20 (IBM Corp., Armonk, New York). Data of women more than 49 years and obstetric hysterectomies were excluded. Results Three hundred sixty-one hysterectomies were received; 157 of which were hysterectomies performed in women of reproductive age for gynecological reasons. The mean age of the women was 40.37 (± 5.47) years. Abnormal uterine bleeding was the most frequent clinical indication for hysterectomy in 81 (51.59%) women, followed by uterine prolapse in 29 (18.47%) and leiomyoma in 22 (14.01%). Common pathologies in the endometrium were endometritis in 14 (8.92%) and endometrial polyp in nine (5.73%). In the myometrium, leiomyoma was reported in 52 (33.12%) cases, adenomyosis in 37 (23.57%), and both leiomyoma and adenomyosis in 37 (23.57%) women. Uterine prolapse was histologically identified in 38 (24.20%) women. Oophorectomy was performed on 107 (68.15%) women, and out of these, 83 (77.59%) women's ovaries showed either normal histology or functional cysts. Ovarian pathologies reported were endometriosis, serous cystadenomas and oophoritis in five patients each (4.81%), ovarian serous carcinoma in three (2.88%), and mucinous carcinoma in one (0.96%) patient. Conclusion Abnormal uterine bleeding was the most common clinical indication for hysterectomy in women of reproductive age. The common pathologies in the hysterectomies were endometritis, endometrial polyp, leiomyoma, adenomyosis, and uterine prolapse. Most of the ovaries removed with the hysterectomy did not show any significant pathology, therefore, further studies in this direction are recommended for confirmation of this finding. Ovarian conservation may be considered in women undergoing hysterectomy for abnormal uterine bleeding or other uterine causes and with no radiological or surgical indication for oophorectomy.
Indications for a Hysterectomy at Jordan University Hospital : A Teaching Hospital Experience
Jordan Medical Journal
Background and Aims: The indications for hysterectomy have changed due to the introduction of many alternatives. However, it is still the most common major gynecological operation. Therefore, this study was conducted to study the indications for a hysterectomy in a teaching hospital. Materials and Methods: This is a retrospective study analyzing the indications for hysterectomy in a teaching hospital over a period of two years (2008-2009). In total, 148 hysterectomies were analyzed. The case notes of these patients were reviewed. Results: The mean age was 46.6 year. Bleeding disorders, uterine fibroids, and abdominal pain were the most frequent indications accounting for 68%. Only 15% were performed due to malignant or premalignant conditions. The final histopathology reports revealed that the most common finding in the uterine specimens was fibroid, which was reported in 50 patients (33.78%), followed by adenomyosis which was reported in 38 patients (25.68%). About 90% of our hysterectomies were carried out through an abdominal route and 10% by the vaginal route. We reported no major complication that endanger the life of the patient as most of the complications were the usual minor postoperative ones ranging from wound infection in 9% to fever and abdominal pain in 1%. Conclusion: The vast majority of hysterectomies were performed to relieve the symptoms of pain, bleeding, or both which means that the indication can be summarized due to discomfort and inconvenience rather than threaten life. It is very clear that age has an important influence on the relative frequency of the indications which are flexible rather than absolute.