Histopathologic audit of hysterectomy specimens in a tertiary care hospital

Aims: To explore the pre-operative diagnosis, surgery performed and histopathological findings in teaching and non teaching hospitals in Chandigarh, India. Methods: A retrospective analysis of preoperative diagnosis made available to the pathologist and the final histopathologic findings was done for age, indication of hysterectomy, type of surgery, hospital setting where surgery was performed and histopathology including gross and microscopic findings of the specimens. Results: A total of 1,270 specimens were analyzed. More hysterectomies for malignant indications were done in teaching than in non teaching hospitals (p <0.001). One or both ovaries were removed in 46% of women undergoing hysterectomy in teaching hospitals and 54.3% in non teaching hospitals. Majority of the women were 30-45 years of age. Fibroid uterus was the commonest indication (246 cases, 40%) followed by prolapsed uterus (141 cases, 23%) and menstrual dysfunction (117 cases, 19%). Majority of the verifiable causes of hysterectomy were confirmed on histopathology. Besides, various incidental findings were noted in majority of the specimens. Conclusions: There were significantly fewer hysterectomies for malignancy and a higher rate of oophorectomies with hysterectomy in non teaching than in teaching hospitals. Regular careful audit and review can help in improving the quality of health care in our country.