Appropriateness of hysterectomy for various indications

Surabhi Bajpai
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2017 · vol. 6(5) , pp. 1956 · doi:10.18203/2320-1770.ijrcog20171956 · W2608156071
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This study analyzed 110 cases advised for hysterectomy, finding that only 27.27% actually required the procedure, while 72.73% could be managed conservatively.

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Abstract

Background: To study appropriateness of hysterectomy for various indications by evaluating the referred cases for hysterectomy as per standard norms and calculating number of hysterectomies which were not indicated.Methods: A prospective study consist of analysis of 110 cases which were advised hysterectomies in different hospitals due to various indications and number of cases who were managed conservatively in these 110 cases and did not required hysterectomy ultimately.Results: There was significant difference in number of cases who were advised hysterectomies and number of cases who actually needed a hysterectomy. Most of cases were advised hysterectomy just on the basis of patient’s complaints with no consideration to age, parity and without proper evaluation as per standard norms.Conclusions: It was found that only 27.27% of cases who were advised hysterectomies actually needed hysterectomy for indications like symptomatic fibroid, severe dysplasia, resistant cases of AUB and intractable pain due to adenomyosis and 72.73% of cases were managed conservatively and indications for which hysterectomy was advised in such cases were inappropriate.
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Background

To study appropriateness of hysterectomy for various indications by evaluating the referred cases for hysterectomy as per standard norms and calculating number of hysterectomies which were not indicated.

Methods

A prospective study consist of analysis of 110 cases which were advised hysterectomies in different hospitals due to various indications and number of cases who were managed conservatively in these 110 cases and did not required hysterectomy ultimately.

Results

There was significant difference in number of cases who were advised hysterectomies and number of cases who actually needed a hysterectomy. Most of cases were advised hysterectomy just on the basis of patient’s complaints with no consideration to age, parity and without proper evaluation as per standard norms.

Conclusions

It was found that only 27.27% of cases who were advised hysterectomies actually needed hysterectomy for indications like symptomatic fibroid, severe dysplasia, resistant cases of AUB and intractable pain due to adenomyosis and 72.73% of cases were managed conservatively and indications for which hysterectomy was advised in such cases were inappropriate. Metrics

References

Statistics Canada, Surgical procedures and treatments. 1992-1993;82-217:32-33. McGlynn EA, Naylor CD, Anderson GM, Leape LL, Parke RE, Hilborne LH, et al. Comparison of the appropriateness of coronary angiography and coronary artery bypass graft surgery between Canada and New York State. JAMA. 1994;272:934-40. Bernstein SJ, Hilborne LH, Leape LL, Park RE, Brook RH. The appropriateness of use of cardiovascular procedures in women and men. Arch Intern Med. 1994;154:2759-65. Broder MS, Kanouse DE, Mittman BS, Bernstein SJ. The appropriateness of recommendations for hysterectomy. Obstetrics and Gynecology. 2000 Feb 29;95(2):199-205. Bachman GA. Hysterectomy: a critical review. J Reprod Med. 1990;35(9):839-62. Lee N, Dicker R, Rubin G, Ory H. Confirmation of the pre-operative diagnosis for hysterectomy. Am J Obstet Gynecol. 1984;150:283-7. SOGC clinical Practice guidelines. 2002;1-12. American College of Obstetricians and Gynaecologists task force on quality assurance. Quality assurance in Obstetrics and Gynaecology. Washington, DC: American College of Obstetricians and Gynaecologists; 1989. Bernstein SJ, McGlynn EA, Siu AL, Roth CP, Sherwood MJ, Keesey JW, et al. The appropriateness of hysterectomy: a comparison of care in seven health plans. Jama. 1993;269(18):2398-402. Mamidi BB. International journal of social work and human services practice. 2013;l(1):64-75.

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adenomyosis

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