An audit of indications and complications associated with elective hysterectomy at SVMCH and RC, Ariyur, Pondicherry

Background: Hysterectomy is the most common gynaecological surgery performed worldwide Menorrhagia secondary to uterine fibroids and abnormal menstrual bleeding are the two most common indications for hysterectomy. An important factor impacting on the incidence of complications of hysterectomy, apart from the indication for surgery, is the surgical approach. Most surgeons perform up to 80% of procedures by the abdominal route. The incidence of LAVH performed for benign lesions has progressively increased in recent years. Methods : Surgical indications and details, histological findings, and postoperative course were reviewed and analysed for 340 patients who underwent hysterectomy in 2011 and 2012.Results : In our study, fibroid uterus (27.9 %) was the leading indication for performing hysterectomies followed by a DUB (22.9%) and uterovaginal prolapse (UVP-21.8%). During the study period (2011-2012), most hysterectomies were performed abdominally (54.4%). Overall post operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the vaginal and laparoscopic group ( p value= 0.001 ). Conclusion: We need to ensure that trainees acquire competency in performing hysterectomies vaginally, which is clearly safer than the abdominal approach.