%0 Journal Article
%T An Audit of Indications, Complications, and Justification of Hysterectomies at a Teaching Hospital in India
%A Deeksha Pandey
%A Kriti Sehgal
%A Aashish Saxena
%A Shripad Hebbar
%A Jayaram Nambiar
%A Rajeshwari G. Bhat
%J International Journal of Reproductive Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/279273
%X Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus. 1. Introduction Hysterectomy is the second most frequently performed major surgical procedures on women all over the world, next only to cesarean. In US, approximately 600,000 hysterectomies are performed each year [1]. In India no national statistics for hysterectomy is available. A study conducted in a northern state of India (Haryana) states that incidence of hysterectomy was 7% among married women above 15 years of age [2]. Another study from a western state (Gujarat) pointed out that 7-8% of rural women and 5% of urban women had already undergone hysterectomy at an average age of 37 years [3]. Indications of hysterectomy vary from benign condition to malignancies of genital tract. Term ¡°hysterectomy¡± though means removal of uterus, in practice it has a much wider classification depending upon the indication. At times it is done without removal of the cervix (supracervical hysterectomy) or with removal of adnexa (hysterectomy with salpingo-oophorectomy). It can also be a part of staging laparotomy or radical hysterectomy. Hysterectomy can be performed abdominally, vaginally or through abdominal ports with help of a laparoscope. Approach depends on surgeon¡¯s preference, indication for
%U http://www.hindawi.com/journals/ijrmed/2014/279273/