A retrospective study on indications and histopathological analysis of non-oncological hysterectomies in a tertiary care hospital

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2020 · vol. 9(12) , pp. 5050 · doi:10.18203/2320-1770.ijrcog20204962 · W3096158908
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AI-generated summary by gemini-2.5-flash-lite, 2026-06-13

This retrospective study assessed hysterectomy indications and found histopathological diagnoses correlated with clinical diagnoses for fibroids, ovarian cysts, and adenomyosis.

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This retrospective study analyzed indications and the agreement between preoperative clinical diagnoses and postoperative histopathological findings in non-oncological hysterectomy specimens from 234 women treated at a tertiary care hospital in Puducherry over 2018. Most procedures were vaginal or abdominal hysterectomy, and histopathology confirmed clinical diagnoses in several diagnostic categories, including ovarian cysts, fibroid with ovarian cyst, and DUB; for fibroids, 66 of 80 cases were confirmed. Adenomyosis was validated in 7 of 9 cases, while endometriosis of the ovary was confirmed in 4 (1.7%) cases, and pelvic organ prolapse specimens showed atrophic changes on histopathology. The paper’s main limitation is its reliance on retrospective chart review and evaluation within a single year and setting. Relevance to endometriosis: it includes histopathological confirmation of ovarian endometriosis (4 cases) among benign hysterectomy indications.

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Abstract

Background: An increase in the number of women undergoing hysterectomy especially in South India is of great concern. Whenever hysterectomy is performed, it is imperative that clinical diagnosis is accurate. The purpose of current study is to assess whether the histopathological diagnosis after surgery is correlated with the clinical diagnosis. Methods: This is a retrospective study conducted in the department of obstetrics and gynaecology at Indira Gandhi medical college and research institute Puducherry, from January 2018 to December 2018. Patients, who underwent hysterectomy for benign causes, were included in the study. Data was collected from the patients' case records. Whether the histopathological diagnosis was in tandem with the clinical diagnosis, was notedResults: Out of the 234 hysterectomies performed, 46.15% were by abdominal route and 53.84% were by vaginal route. 24.7% were TAH with BSO with mean age of 49.72 years. VH with PFR (46.5%) was the most common surgery done. Out of the 80 cases of fibroid, 66 (28.2%) were confirmed on histopathology. Histopathological diagnosis corroborated the clinical diagnosis in patients with ovarian cyst, fibroid with ovarian cyst and DUB. Adenomyosis was validated in 7 of 9 cases. Endometriosis of ovary was confirmed in 4 (1.7%) cases. In patients with pelvic organ prolapse, histopathology showed atrophic changes.Conclusions: Accurate clinical diagnosis, supported by in-depth preoperative evaluation and a sound clinical knowledge helps to avoid unnecessary hysterectomies. It is imperative to study the histopathology of the operated specimen and confirm the appropriateness of the clinical indication.
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Background

An increase in the number of women undergoing hysterectomy especially in South India is of great concern. Whenever hysterectomy is performed, it is imperative that clinical diagnosis is accurate. The purpose of current study is to assess whether the histopathological diagnosis after surgery is correlated with the clinical diagnosis.

Methods

This is a retrospective study conducted in the department of obstetrics and gynaecology at Indira Gandhi medical college and research institute Puducherry, from January 2018 to December 2018. Patients, who underwent hysterectomy for benign causes, were included in the study. Data was collected from the patients' case records. Whether the histopathological diagnosis was in tandem with the clinical diagnosis, was noted

Results

Out of the 234 hysterectomies performed, 46.15% were by abdominal route and 53.84% were by vaginal route. 24.7% were TAH with BSO with mean age of 49.72 years. VH with PFR (46.5%) was the most common surgery done. Out of the 80 cases of fibroid, 66 (28.2%) were confirmed on histopathology. Histopathological diagnosis corroborated the clinical diagnosis in patients with ovarian cyst, fibroid with ovarian cyst and DUB. Adenomyosis was validated in 7 of 9 cases. Endometriosis of ovary was confirmed in 4 (1.7%) cases. In patients with pelvic organ prolapse, histopathology showed atrophic changes.

Conclusions

Accurate clinical diagnosis, supported by in-depth preoperative evaluation and a sound clinical knowledge helps to avoid unnecessary hysterectomies. It is imperative to study the histopathology of the operated specimen and confirm the appropriateness of the clinical indication. Metrics

References

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