A study on elective hysterectomies in a Tertiary care hospital

Abstract

In spite of availability of many conservative methods to treat various benign gynaecological disorders, hysterectomy remains the mainstay of treatment. This is a hospital based Cross sectional study on 200 cases of elective hysterectomies carried out in the department of Obstetrics & Gynaecology, Fakir Mohan Medical College and Hospital Balasore, Odisha, India, from November 2018 to October 2020. Findings related to age, clinical presentations, indications, route of surgery, concurrent removal of ovaries, complications and histopathological study of uterine specimen were recorded and statistically analyzed.48% were between the age group of 41-50 years. 52% presented with heavy menstrual bleeding. In 59% cases fibroid uterus was the indication for hysterectomy. 80% underwent abdominal hysterectomy and 20% vaginal hysterectomy. Both ovaries were removed in 55% cases. 3 % cases had intraopertive bleeding and 4% had wound gaping who required secondary suturing. Histopathological study of uterine specimen revealed endometrial hyperplasia in 14 % cases, non specific chronic cervicitis in 92% cases and leiomyoma in 59% cases. Heavy menstrual bleeding is the most common clinical presentation. Leiomyoma being the most common indication for hysterectomy. Abdominal route is preferred over vaginal route. Ovaries are preserved in several cases. Bleeding and wound gaping are the most common surgical complications. Proper selection of cases reduces the complication rate.