Audit of Gynaecological Hysterectomies

Objective: To audit indications, histopathological diagnosis and complications of gynaecological hysterectomies performed at Social Security Hospital, Lahore. Study design: Retrospective study Place and duration of study: Department of Obstetrics and Gynaecology, Social Security Hospital,Lahore from 1 st January to 31 st December,2010. Methodology: Data regarding patient characteristics, indications and operative and postoperative morbidity of gynaecological hysterectomies performed during one year was collected from files and patients records. Histopathology reports of these patients were collected from the department of pathology. The results were analyzed by percentages. Results: Total of 115 hysterectomies were performed in the year 2010. The ratio of abdominal to vaginal hysterectomy was 5:1 Mean age of patients was 46 years (range 35 – 67 years) and parity ranged from zero to eight. Most common presenting complaint was excessive menstrual blood loss in 79 patients (68.6%) followed by something coming out of vagina in 20 patients (17.4%). Majority of indications were benign. Most common preoperative diagnosis was fibroid uterus in 38 patients (33%) followed by dysfunctional uterine bleeding in 25 (21.7%). The most common histopathological diagnosis made was that of fibroid in 41.7% of cases. The commonest incidental histopathological finding seen in hysterectomy specimens was chronic cervicitis. Most of the hysterectomies were performed under spinal anaesthesia with smooth postoperative recovery. Conclusion: A yearly audit should be conducted in every institute to analyze the pattern of indications and lesions found on histopathological examination. The clinical indication for hysterectomy and histopathological outcome are comparable in over 90% of cases.