CLINICO-PATHOLOGICAL STUDY OF ABDOMINAL HYSTERECTOMIES

Riffat Jaleel, Ayesha Khan, Nargis Soomro
In: Pakistan Journal of Medical Sciences · 2009 · vol. 25(4) , pp. 630–634 · W2162798017
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This study correlated indications for abdominal hysterectomy with histopathology, finding high confirmation rates for most diagnoses but significant discrepancies for dysfunctional uterine bleeding.

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Abstract

Objectives: To correlate indications of abdominal hysterectomy with the histo-pathological findings, in order to determine the percentage of pre-operative diagnosis that was confirmed on histopathology and to determine the frequency of unexpected pathologies. Methodology: This cross sectional study was conducted in the Department of Obstetrics and Gynecology, Unit II, Civil Hospital Karachi, during January 1995 to December 1996 and Department of Obstetrics and Gynecology, Unit V, Dow Medical College and Lyari General Hospital, Karachi, during August 2005 and October 2008. One hundred sixty six patients undergoing abdominal hysterectomy for gynecological disease, were studied. Data was recorded on proformas, including demographic characteristics and clinical features. Indication for the procedure was documented. Surgical specimens were sent for histopathology and reports were analyzed and compared with the indications of surgery. Results: Commonest indication for hysterectomy was fibroid in 40% followed by dysfunctional uterine bleeding (DUB) in 29% cases. Histopathological confirmation of pre-operative diagnosis was 100% for malignancy, endometrial hyperplasia, endometritis and hydatidiform mole, 94% for fibroids, 83% for adenomyosis, 60% for pelvic inflammatory disease and 14.1% for DUB. Majority of cases (65%) pre-operatively diagnosed as DUB were found to have adenomyosis. One case of undifferentiated uterine sarcoma was discovered on histopathology. Conclusions: Histo-pathological analysis correlates well with the pre-operative diagnosis / indication for hysterectomy. Histo-pathology is mandatory for ensuring diagnosis and thus management, in particular of malignant disease.

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adenomyosis

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