An audit of hysterectomies at a tertiary care teaching hospital

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2018 · vol. 7(7) , pp. 2874 · doi:10.18203/2320-1770.ijrcog20182898 · W2811092651
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AI-generated summary by claude@2026-06, 2026-06-13

This audit of 250 hysterectomies performed in 2017 found fibroid uterus was the most common indication, with most patients aged 40-49, and the abdominal route preferred.

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This one-year tertiary care hospital audit analyzed all patients undergoing hysterectomy from January to December 2017, reporting demographics, surgical approach, and the recorded indications with postoperative histopathology justification. Among 250 hysterectomies, the most common age group was 40–49 years (36.8%), and the leading indication was fibroid uterus (40%), followed by ovarian cysts (noted as “ca ovary” at 19.6%), with the abdominal route most frequently used. The authors state hysterectomy was justified in 98% of cases based on postoperative histopathology, but hypothesize that some cases (e.g., DUB, CIN, endometriosis, chronic cervicitis) might have been managed conservatively, and that some obstetric hysterectomies could have been avoided with improved referral and conservative uterine artery embolization approaches. Relevance to endometriosis: the paper explicitly lists endometriosis among conditions they hypothesize could have been managed conservatively instead of hysterectomy, even though the overall focus is a hysterectomy indication audit.

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Abstract

Background: Hysterectomy is the second most common major surgical procedure performed on women all over the world next to caesarean section. Emergence of effective medical and conservative treatment for benign conditions in the uterus is now posing a question mark regarding the justification of hysterectomy. It has been realized that uterus should not be considered as a vestigial organ after child bearing. Apart from few population based studies, there is no national level survey done in India which give us the prevalence and indications for hysterectomy in India.Methods: Present study involved all patients who underwent Hysterectomy at Guru Gobind Singh Medical College Faridkot in a span of one year from 1st January 2017 to 31st December 2017.Results: In the year 2017, 250 hysterectomies were done, most common age group was 40-49 years (36.8%) and most common indication was fibroid uterus (40%) followed by ca ovary (19.6%), Abdominal route was most commonly preferred.Conclusions: Hysterectomy was justified in 98% women in our series based on post operative histopathological report of the specimen. However we hypothesize that 20 cases of DUB, 5 cases of CIN and 10 cases of endometriosis and 3 cases of chronic cervicitis could have been managed conservatively. 10 cases of obstetric hysterectomies could have been avoided by disseminating awareness among peripheral centres for early referral and by attempting a rather conservative approach of uterine artery embolizations. As the incidence of carcinoma is increasing in the Malwa region of Punjab people prefer hysterectomies instead of conservative treatment. Hysterectomy is used commonly to improve the quality of life and sometime it is life saving procedure. However it should be justified before taking a direct decision of sacrificing uterus.
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Background

Hysterectomy is the second most common major surgical procedure performed on women all over the world next to caesarean section. Emergence of effective medical and conservative treatment for benign conditions in the uterus is now posing a question mark regarding the justification of hysterectomy. It has been realized that uterus should not be considered as a vestigial organ after child bearing. Apart from few population based studies, there is no national level survey done in India which give us the prevalence and indications for hysterectomy in India.

Methods

Present study involved all patients who underwent Hysterectomy at Guru Gobind Singh Medical College Faridkot in a span of one year from 1st January 2017 to 31st December 2017.

Results

In the year 2017, 250 hysterectomies were done, most common age group was 40-49 years (36.8%) and most common indication was fibroid uterus (40%) followed by ca ovary (19.6%), Abdominal route was most commonly preferred.

Conclusions

Hysterectomy was justified in 98% women in our series based on post operative histopathological report of the specimen. However we hypothesize that 20 cases of DUB, 5 cases of CIN and 10 cases of endometriosis and 3 cases of chronic cervicitis could have been managed conservatively. 10 cases of obstetric hysterectomies could have been avoided by disseminating awareness among peripheral centres for early referral and by attempting a rather conservative approach of uterine artery embolizations. As the incidence of carcinoma is increasing in the Malwa region of Punjab people prefer hysterectomies instead of conservative treatment. Hysterectomy is used commonly to improve the quality of life and sometime it is life saving procedure. However it should be justified before taking a direct decision of sacrificing uterus. Metrics

References

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