Clinico-Pathological Study of Hysterectomy Specimens in Kathmandu Medical College Teaching Hospital

Sailesh Pradhan, Mamata Sedhain, Sneh Acharya, Sailuja Maharjan, Samikchhya Regmi
In: Birat Journal of Health Sciences · 2018 · vol. 3(2) , pp. 423–426 · doi:10.3126/bjhs.v3i2.20938 · W2890086154
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This study of 198 hysterectomy specimens identified leiomyoma as the most common pathology and indication for surgery, followed by adenomyosis and abnormal uterine bleeding.

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This cross-sectional clinico-pathological study reviewed all hysterectomy specimens sent for histopathology at Kathmandu Medical College Teaching Hospital from January 2016 to December 2017 (n=198), using information from requisition forms to correlate clinical findings with diagnoses. The most common uterine pathology was leiomyoma (60.0%), followed by adenomyosis (14.0%), with atrophic endometrium present in 24.3% of cases; chronic cervicitis was reported in most cases (96.5%) along with endocervical polyps in 8.1%. Leiomyoma accounted for the most frequent hysterectomy indication (48.0%), with abnormal uterine bleeding and utero-vaginal prolapse also common, and total abdominal hysterectomy with bilateral salpingo-oophorectomy was the predominant procedure. The paper’s limitation is that it is based on hysterectomy specimens and does not capture non-hysterectomized uterine/cervical disease, restricting how broadly its findings can be generalized. Relevance to endometriosis: adenomyosis findings are directly included, and the paper also reports adenomyosis among hysterectomy pathologies, though it does not explicitly focus on endometriosis or compare disease mechanisms.

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Abstract

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.
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Introduction

Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.

Objective

To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings. Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.

Results

A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.

Conclusion

Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426. Downloads Downloads Published How to Cite Issue Section License This license allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator.

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