A 2 year histopathological audit for non-oncological hysterectomies in a tertiary care hospital

Salma Bhat, Nazia Bhat, Isma Niyaz, Rohi Wani
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2017 · vol. 6(8) , pp. 3260 · doi:10.18203/2320-1770.ijrcog20173145 · W2731700951
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This two-year audit of non-oncological hysterectomies found that symptomatic fibroids were the most common indication, with adenomyosis listed as a key surgical target, while approximately half of specimens lacked identified pathology.

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This two-year retrospective audit evaluated the correlation between preoperative diagnoses and final histopathological findings for non-oncological hysterectomies at a tertiary care hospital. The study analyzed consecutive specimens, excluding confirmed malignancies, to assess surgical indications such as symptomatic fibroids, prolapse, and obstetric causes. Results indicated that while symptomatic fibroid uterus was the most common indication, approximately half of all hysterectomy specimens revealed no identifiable pathology on histological examination. Relevance to endometriosis: adenomyosis is listed in the background as one of the diseases treated by hysterectomy, though the paper's main focus is a general audit of surgical indications rather than specific analysis of endometriosis or adenomyosis pathology.

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Abstract

Background: Hysterectomy is the most common gynecological surgery in the world and is considered to be the most definitive treatment option for various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimensMethods: This was a retrospective audit. The pre-operative diagnosis and histopathologic data of all consecutive specimens of hysterectomies were collected and analysed. Those with confirmed malignancy before operation were excluded. All elective as well as emergency hysterectomies (including obstetric hysterectomies) were analyzed. Preoperative indications were compared with the final histopathological report.Results: Most common indication for hysterectomy was symptomatic fibroid uterus followed by utero-vaginal prolapse and obstetric causes. Overall, there was no pathology identified in approximately 50% of all hysterectomies received in our department.Conclusions: Proper audit and review can help in improving the quality of health care in our country. The results of our study may help to reduce inappropriate indications for hysterectomy.
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Background

Hysterectomy is the most common gynecological surgery in the world and is considered to be the most definitive treatment option for various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens

Methods

This was a retrospective audit. The pre-operative diagnosis and histopathologic data of all consecutive specimens of hysterectomies were collected and analysed. Those with confirmed malignancy before operation were excluded. All elective as well as emergency hysterectomies (including obstetric hysterectomies) were analyzed. Preoperative indications were compared with the final histopathological report.

Results

Most common indication for hysterectomy was symptomatic fibroid uterus followed by utero-vaginal prolapse and obstetric causes. Overall, there was no pathology identified in approximately 50% of all hysterectomies received in our department.

Conclusions

Proper audit and review can help in improving the quality of health care in our country. The results of our study may help to reduce inappropriate indications for hysterectomy. Metrics

References

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