Post- tubal ligation hysterectomy.

The study purpose was to determine to what extent the tubal ligation operation was responsible for a hysterectomy at a later date. Materials were collected from Eden Hospital, Medical College and Hospitals in Calcutta, India over the August 1974-July 1979 period. A total of 298 hysterectomies were performed during this period. Of these, 36 patients had previous ligation of tubes. All of these cases were studied clinically during preoperative, operative, and postoperative periods. Their histopathological reports were scrutinized. Findings of postligation hysterectomy cases were compared with that of nonligation cases. Postligation cases were labeled as group 1 and nonligation cases as group 2. Out of 36 cases in group 1, only 2 patients attended after mneopause. In regard to the ligation hysterectomy interval, it was less than 5 years in 3 cases, between 5-10 years in 12 cases, between 11-15 years in 10 cases, and between 16-20 years in 10 cases. Only 1 case had a ligation-hysterectomy interval of 21 years or more. The patient who attended within 8 years usually came with symptoms of uterine prolapse, excessive white discharge, and in 2 cases with lump abdomen for hydrosalpinx. Menorrhagia, dysmenorrhea, and acute abdominal symnptoms were more common among postligation patients. Fibroid, endometriosis, hydrosalpinx, polycystic ovary, endometrial polyp, and dysfunctional uterine hemorrhage were more common among postligation cases than in the nonligation group. Of the 2 cases of death in group 2, 1 case of malignant ovarian tumor died within 24 hours of the operation and the other patient died on the 8th postoperative day after Wertheim's operation. In group 1 there was no mortality. Morbidity was not much different among the 2 groups. Thus the risk of operation among postligation cases was as minimum as in other cases.