Clinico-histopathological correlation of abdominal hysterectomy

Sayeda Niger Sultana, Afrin Akter Sony, Moriam Pervin, M. A. Hamid
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(9) , pp. 2337 · doi:10.18203/2320-1770.ijrcog20222055 · W4289516863
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This study correlated clinical indications for abdominal hysterectomy with histopathological findings, finding leiomyoma to be the most common indication with a high diagnostic correlation.

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This descriptive study from a single gynecology department in Dhaka (August 2010–January 2011) analyzed 100 patients who underwent abdominal hysterectomy, aiming to correlate preoperative clinical diagnoses and indications with postoperative histopathology. The most common clinical diagnosis was uterine leiomyoma (52%), followed by dysfunctional uterine bleeding (30%); adenomyosis (7%) and endometriosis (6%) were also reported among the preoperative diagnoses, and some cases had combined pathology (53 cases). Histopathology correlated well with clinical and radiological assessments for leiomyoma (94.23%), while dysfunctional uterine bleeding functioned as a diagnosis of exclusion, with the paper implying that histology is necessary for confirmation. This paper is centrally about endometriosis and adenomyosis only insofar as it includes their preoperative clinical diagnoses and corresponding histopathological findings among the indications for abdominal hysterectomy.

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Abstract

Background: Hysterectomy is the most common gynaecological procedure performed. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. It is still considered as the treatment of choice for benign lesion such as leiomyoma, adenomyosis, extensive pelvic infection or adhesions, dysfunctional uterine bleeding and obstetric complications. Objectives were to correlate the indications of abdominal hysterectomy to histopathological findings thus, determining histologically confirmed preoperative clinical diagnosis.Methods: This study was conducted at the department of obstetrics and gynaecology, Bangabandhu Sheikh Mujib medical university, Dhaka from August 2010 to January 2011. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.Results: One hundred patients undergoing abdominal hysterectomy were studied. Data were recorded on structured proforma, including demographic characteristics, clinical features and indications of the procedure. In. our study, it was observed that the most common clinical diagnosis was leiomyoma of uterus 52 (52%). Other clinical diagnosis was DUB in 30 cases (30%), adenomyosis in 7 cases (7%), endometriosis in 6 cases (6%). Pelvic inflammatory disease in 3 cases (3%), endometrial polyp (2%). Abdominal hysterectomy was the single approach done in these cases. Clinical, radiological as well as histopathology report correlated uterine leiomyoma very well and it was about 94.23%, while DUB was a disease of exclusion. In 53 cases combined pathology was found.Conclusions: Hysterectomy is currently the most widely performed major operation in gynaecology and histopathology is mandatory for ensuring diagnosis and management. With the improvement in the different organ preserving options, hysterectomy in benign disease should only be opted when all the other conservative options failure.
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Background

Hysterectomy is the most common gynaecological procedure performed. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. It is still considered as the treatment of choice for benign lesion such as leiomyoma, adenomyosis, extensive pelvic infection or adhesions, dysfunctional uterine bleeding and obstetric complications. Objectives were to correlate the indications of abdominal hysterectomy to histopathological findings thus, determining histologically confirmed preoperative clinical diagnosis.

Methods

This study was conducted at the department of obstetrics and gynaecology, Bangabandhu Sheikh Mujib medical university, Dhaka from August 2010 to January 2011. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.

Results

One hundred patients undergoing abdominal hysterectomy were studied. Data were recorded on structured proforma, including demographic characteristics, clinical features and indications of the procedure. In. our study, it was observed that the most common clinical diagnosis was leiomyoma of uterus 52 (52%). Other clinical diagnosis was DUB in 30 cases (30%), adenomyosis in 7 cases (7%), endometriosis in 6 cases (6%). Pelvic inflammatory disease in 3 cases (3%), endometrial polyp (2%). Abdominal hysterectomy was the single approach done in these cases. Clinical, radiological as well as histopathology report correlated uterine leiomyoma very well and it was about 94.23%, while DUB was a disease of exclusion. In 53 cases combined pathology was found.

Conclusions

Hysterectomy is currently the most widely performed major operation in gynaecology and histopathology is mandatory for ensuring diagnosis and management. With the improvement in the different organ preserving options, hysterectomy in benign disease should only be opted when all the other conservative options failure. Metrics

References

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