Patterns of Lesions in Hysterectomy Specimens in a Tertiary Care Hospital

Sujan Vaidya, S Vaidya, Vaidya S, Sapana Amatya Vaidya, S A Vaidya, Vaidya SA
JNMA; journal of the Nepal Medical Association · 2015 · vol. 53(197) , pp. 18–23 · doi:10.31729/jnma.2698 · PMID:26983042 · W1556055238
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This study analyzed 533 hysterectomy specimens, finding fibroids to be the most common indication and leiomyoma the most frequent pathology, with pre-operative diagnoses correlating well with histopathology in most cases.

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This two-year descriptive study analyzed the histopathological patterns of 533 hysterectomy specimens collected at a tertiary care hospital in Nepal to correlate pre-operative clinical diagnoses with final pathological findings. Leiomyoma was identified as the most common pathology, occurring in nearly half of the cases, while uterovaginal prolapse and ovarian tumors also represented significant portions of the cohort. The research demonstrated that pre-operative indications were verifiable through histopathology in over 91% of cases, though incidental lesions were frequently discovered, underscoring the necessity of mandatory examination for all specimens. Relevance to endometriosis: listed as one indication for hysterectomy in the introduction, though the paper's main focus is uterine fibroids.

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Abstract

INTRODUCTION: Hysterectomy is one of the most common gynaecological procedures performed all over the world. The most frequent indications for hysterectomy are fibroids, abnormal uterine bleeding uterovaginal prolapse and endometriosis. The objective of this study was to present the histopathological patterns of various uterine and adnexal pathologies in the hysterectomy specimens and also to correlate its pre-operative clinical diagnosis with histopathology. METHODS: This is a two-year descriptive study of hysterectomy specimens carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all the hysterectomy specimens collected during this period was analyzed. RESULTS: Out of the 533 cases, fibroid was the most common indication for hysterectomy that was seen in 229 (42.94%) cases followed by uterovaginal prolapse in 101 (18.93%) cases. Leiomyoma was the most common pathology reported in 250 (46.90%) hysterectomy specimens, followed by ovarian tumours in 95 (17.82%) cases. In 17.82% (95/533) cases, no pathology was seen. Overall, the pre-operative indications in 533 cases of hysterectomy were histopathologically verifiable in 487 (91.37%) cases. CONCLUSIONS: Though the histopathological examination correlates well with the pre-operative clinical diagnosis, a number of lesions were also encountered as pure incidental findings. Hence, it is mandatory that every hysterectomy specimen should be subjected to histopathological examination so as to ensure better post-operative management.
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Introduction

Hysterectomy is one of the most common gynaecological procedures performed all over the world. The most frequent indications for hysterectomy are fibroids, abnormal uterine bleeding uterovaginal prolapse and endometriosis. The objective of this study was to present the histopathological patterns of various uterine and adnexal pathologies in the hysterectomy specimens and also to correlate its pre-operative clinical diagnosis with histopathology.

Methods

This is a two-year descriptive study of hysterectomy specimens carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all the hysterectomy specimens collected during this period was analyzed.

Results

Out of the 533 cases, fibroid was the most common indication for hysterectomy that was seen in 229 (42.94%) cases followed by uterovaginal prolapse in 101 (18.93%) cases. Leiomyoma was the most common pathology reported in 250 (46.90%) hysterectomy specimens, followed by ovarian tumours in 95 (17.82%) cases. In 17.82% (95/533) cases, no pathology was seen. Overall, the pre-operative indications in 533 cases of hysterectomy were histopathologically verifiable in 487 (91.37%) cases.

Conclusions

Though the histopathological examination correlates well with the pre-operative clinical diagnosis, a number of lesions were also encountered as pure incidental findings. Hence, it is mandatory that every hysterectomy specimen should be subjected to histopathological examination so as to ensure better post-operative management.

Keywords

adenomyosis; hysterectomy; leiomyoma; tumour; uterovaginal prolapse.Downloads Published How to Cite Issue Section License JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.

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Condition tags

endometriosis

MeSH descriptors

Hysterectomy Hysterectomy Leiomyoma Ovarian Neoplasms Ovariectomy Ovariectomy Tertiary Care Centers Uterine Neoplasms Adolescent Adult Aged Aged, 80 and over Child Female Genital Diseases, Female Genital Diseases, Female Humans Hysterectomy, Vaginal Hysterectomy, Vaginal Leiomyoma

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