Profile of Hysterectomy at a Teaching Hospital in India Over 5 Years

Abstract

Abstract

Objective:

The aim of this study was to analyze indications, surgical routes, complications, and histopathologic correlations with preoperative diagnoses for all patients who underwent hysterectomies at a new teaching hospital over 5 years.

Materials and Methods:

This retrospective observational study included all women who underwent hysterectomy at a new medical college hospital in India from 2013 to 2017.

Results:

Hysterectomy was performed in 1.4% women attending the hospital's gynecologic outpatient department. Abdominal hysterectomy (72.7%) was the most-common surgical approach, followed by vaginal (18.6%) and laparoscopic (8.6%) approaches. The most-common indications for hysterectomy were symptomatic fibroid uteri (39.8%) and uterovaginal prolapse (17.6%). The overall complication rate was 7.1%. Preoperative diagnoses were confirmed by histopathology in 88.2% cases. The highest correlation (94%) was for fibroids and lowest correlation (70%) was for premalignant cervical lesions.

Conclusions:

Hysterectomy, as a definitive surgery in symptomatic women with benign pathologies, provides permanent relief. Patient satisfaction far outweighs short-term complications. Vaginal hysterectomy should be the default route. Prophylactic oophorectomy should be considered only after assessing the potential consequences of estrogen deficiency or subsequent ovarian malignancy. An audit of hysterectomies and major gynecologic surgeries is an indirect health indicator. The gynecologic work in the first 5 years of the new medical college hospital was almost on a par with major studies across countries. Shared decision making is definitely preferred when considering hysterectomy.