Abstract
Background: Hysterectomy is a major gynaecological operation for removal of the uterus with or without the cervix and adnexal structures for therapeutic purpose. There is paucity of data on gynaecological hysterectomy for benign disorders in our environment.
Objective: This study sought to determine the prevalence and indications for gynaecological hysterectomy for benign conditions, evaluate the surgical outcome and assess the associated factors in women.
Methodology: This was a retrospective review of gynaecological hysterectomies performed between March 2015 and February 2021. Data were obtained from operating theater and gynaecological ward records. Information on maternal age, parity, indication for surgery, length of surgery, estimated blood loss and any blood transfusion, post-operative complication, and mortality, were extracted. Data were analyzed using SPSS version 20. Categorical measurements were given as numbers and percentages, and numerical measurements as mean and standard deviation. The Chi-square test or Fisher exact test and analysis of variance test were used for statistical analysis of non-continuous and continuous variables as appropriate and statistical significance was set at p < 0.05.
Results: There were 1240 major gynaecological surgeries, of which 157 were hysterectomies for benign conditions, giving a prevalence of 12.7%, 112 (71.3%) were abdominal hysterectomies and 45 (28.7%) were vaginal hysterectomies, giving a ratio of 2.5:1. The mean age ± SD was 50.71 ± 10.46 years and median parity was 4. There was significant association between age (P = 0.00001) and parity (P = 0.0001) with the type of hysterectomy performed. The commonest indication was uterine fibroid 89 (56.6%), followed by uterovaginal prolapse 45 (28.7%). The commonest complication was anaemia in 29 (18.5%), followed by wound sepsis in 25 (15.9%). Intraoperative injury occurred in 5 (3.2%) and there was one maternal death (0.6%). There was significant association between duration of surgery with anaemia (P = 0.0001) and women < 49 years were 3x likely to have significant blood loss at hysterectomy than those ≥ 49 years.
Conclusion: The prevalence of benign hysterectomy of 12.7% shows it’s a common procedure and the complication rates shows it’s a relatively safe procedure. Uterine fibroid is the commonest indication for the abdominal route and utero-vaginal prolapse for the vaginal route. Age and parity were determinants for the route, while duration of surgery and blood loss were determinants for complication. Younger and low parity women, who mainly undergo abdominal hysterectomy, were likely to have significant blood loss at surgery.
Keywords: Benign Gynaecological Conditions, Abdominal Hysterectomy; Vaginal Hysterectomy; Uterine Fibroids; Utero-Vaginal Prolapse
References
- Howard WJ. “Abdominal hysterectomy”. In: John AR, Howard WR. editors. Te Linde’s Operative Gynecology. 10th ed. Philadelphia; Lippincott Williams and Wilkins (2008): 727-733.
- Umeora OU., et al. “Abdominal versus vaginal hysterectomy: Appraisal of indications and complications in a Nigerian federal medical center”. Nepal Journal of Obstetrics and Gynaecology 4 (2009): 25-29.
- Onah HE and Ugona MC. “An audit of vaginal hysterectomy in Enugu, Nigeria”. The Journal is Official Publication of Society of Gynecology 21 (2004): 58-60.
- Jain SB and Chandrakar KD. “Non-decent vaginal hysterectomy in rural setup of MP: A poor acceptance”. The Journal of Obstetrics and Gynecology of India 66 (2016): 499-504.
- Domingo S and Pellicer A. “Overview of current trends in hysterectomy”. Expert Review of Obstetrics and Gynecology 4 (2009): 673-685.
- Shiota M., et al. “Total abdominal hysterectomy versus laparoscopically assisted vaginal hysterectomy versus total vaginal hysterectomy”. Asian Journal of Endoscopic Surgery 4 (2011): 161-165.
- Ikechebelu JI., et al. “Laparoscopically assisted vaginal hysterectomy in Southeast Nigeria – a case report”. Nigerian Medical Journal 18 (2009): 107-109.
- Olusegun O., et al. “Total laparoscopic hysterectomy: a case report from ILE-IFE, Nigeria”. Nigerian Medical Journal4 (2012): 254-256.
- Akintobi A., et al. “Laparoscopic supracervical hysterectomy and uterine morcellation: a case report from Asokoro District Hospital, Abuja, Nigeria”. Nigerian Journal of Clinical Practice6 (2015): 824-827.
- Daru PH., et al. “Vaginal hysterectomy at Jos university teaching hospital, Jos, Nigeria”. Journal of the West African College of Surgeons3 (2011): 26-36.
- Goolab BD. “Vaginal hysterectomy and relative merits over abdominal and laparoscopically assisted hysterectomy”. Best Practice and Research Clinical Obstetrics and Gynecology 27 (2013): 393-413.
- Danielle DM and Amy JP. “The Challenging Vaginal Hysterectomy”. Postgraduate obstetrics and gynecology22 (2010): 1-7.
- Choosing the Route of Hysterectomy for Benign Disease. ACOG Committee Opinion No. 444”. American College of Obstetricians and Gynecologists, Obstetrics and Gynecology 114 (2009): 1156-1158.
- Andrew IB. “Hysterectomy in the 21ST Century: Different Approaches, Different Challenges”. Clinical Obstetrics and Gynecology4 (2006): 722-735.
- Medhi P., et al. “A histopathological audit of hysterectomy: experience at a tertiary teaching hospital”. International Journal of Contemporary Medical Research4 (2016): 1226-1228.
- Hammer A., et al. “Global epidemiology of hysterectomy: possible impact on gynecological cancer rates”. American Journal of Obstetrics and Gynecology1 (2015): 23-29.
- Arowojolu AO. “Hysterectomy”. In: Okonofua F, Odunsi K (edition.) Contemporary Obstetrics and Gynaecology for Developing Countries. Benin City. Women’s Health and Action Research Centre (2003): 227-242.
- Omokanye LO., et al. “Hysterectomy at the university of Ilorin teaching hospital, Ilorin, Nigeria: A ten year review”. The Nigerian Medical Practitioner 61 (2012): 104-108.
- Roberts OA and Okunlola MA. “Abdominal hysterectomy for benign gynaecological conditions at Ibadan, Nigeria”. Tropical Journal of Obstetrics and Gynaecology 18 (2001): 19-23.
- Shafi MI. “Premalignant and malignant diseases of the cervix”. In: Edmonds DK, editor. Dewhurst’s Textbook of Obstetrics and Gynaecology. 8TH edition. UK: Wiley-Blackwell Publishing Ltd (2012): 742-759.
- Obilahi A., et al. “Hysterectomy in the Niger-Delta of Nigeria: A clinical study of indications and outcome”. Greener Journal of Medical Sciences 3 (2013): 160-165.
- Rabiu A and Habib R. “Elective abdominal hysterectomy: Appraisal of indications and complications at Aminu Kano Teaching Hospital – An 8-year review”. Tropical Journal of Obstetrics and Gynaecology 34 (2017): 224-228.
- Oseki C and Osaikhuwuomwan JA. “A review of indications and outcome of total abdominal hysterectomy at a tertiary public health facility in Southern Nigeria”. Nigerian Journal of Clinical Research 7 (2018): 21-24.
- Bukar M., et al. “Hysterectomy for benign gynaecological conditions at Gombe, Northeastern Nigeria”. Nigerian Journal of Medicine1 (2010): 35-38.
- Anzaku AS and Musa J. “Total abdominal hysterectomy for benign gynaecological conditions at a university Teaching Hospital in Nigeria”. Nigerian Journal of Medicine3 (2012): 326-330.
- Abah MG and Olatunbosun OA. “An audit of gynaecological hysterectomies in the university of Uyo teaching hospital: Case for non-descent”. International Journal of Clinical Obstetrics and Gynecology5 (2019): 161-165.
- Adenaya OR., et al. “Pattern of Gynaecological Total Abdominal Hysterectomy (TAH) in Abeokuta, Southwest Nigeria; a Five-Year Review”. Journal of Medical Science and Clinical Research5 (2020): 297-304.
- Tinkishea EA., et al. “Prevalence, indication, type and complication of elective hysterectomy in a tertiary hospital in Ethiopia”. Ethiopian Journal of Reproductive Health3 (2019): 1-7.
- Obiechina NJ., et al. “Vaginal hysterectomy in a Nigerian tertiary health facility”. Nigerian Journal of Medicine 19 (2010): 324-325.
- Rasheed S., et al. “Frequency of Complications Among Total Abdominal Hysterectomy Patients in Rehman Medical Institute Hayatabad Peshawar”. The Jena School for Microbial Communication2 (2018): 138-142.
Journal Menu
PubMed Indexed Article
EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.
PMID: 31143884 [PubMed]
PMCID: PMC6536005
EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.
PMID: 31565701 [PubMed]
PMCID: PMC6764777
EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.
PMID: 27747317 [PubMed]
PMCID: PMC5065347
EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?
PMID: 31460519 [PubMed]
PMCID: PMC6711478
EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?
PMID: 30215059 [PubMed]
PMCID: PMC6133253
EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.
PMID: 30417173 [PubMed]
PMCID: PMC6226033
EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.
PMID: 30264037 [PubMed]
PMCID: PMC6155992
EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.
PMID: 30198026 [PubMed]
PMCID: PMC6124505
EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.
PMID: 30294723 [PubMed]
PMCID: PMC6169793
EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs
PMID: 29285526 [PubMed]
PMCID: PMC5743211
EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique
PMID: 29911204 [PubMed]
PMCID: PMC5999047
EC Microbiology
Macrophages and the Viral Dissemination Super Highway
PMID: 26949751 [PubMed]
PMCID: PMC4774560
EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.
PMID: 27390782 [PubMed]
PMCID: PMC4933318
EC Microbiology
Reactive Oxygen Species in HIV Infection
PMID: 28580453 [PubMed]
PMCID: PMC5450819
EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population
PMID: 26280024 [PubMed]
PMCID: PMC4533840
EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis
PMID: 28066845 [PubMed]
PMCID: PMC5214344
EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology
PMID: 28936490 [PubMed]
PMCID: PMC5604476
EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia
PMID: 28713879 [PubMed]
PMCID: PMC5510658
EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature
PMID: 28133641 [PubMed]
PMCID: PMC5267489
EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling
PMID: 29333536 [PubMed]
PMCID: PMC5766278
EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.
PMID: 31032493 [PubMed]
PMCID: PMC6483108
EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.
PMID: 30957099 [PubMed]
PMCID: PMC6448571
EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.
PMID: 30101228 [PubMed]
PMCID: PMC6086333
EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.
PMID: 31080964 [PubMed]
PMCID: PMC6508883
EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.
PMID: 31093608 [PubMed]
PMCID: PMC6513001
EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.
PMID: 31552397 [PubMed]
PMCID: PMC6758937
EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.
PMID: 31681909 [PubMed]
PMCID: PMC6824723
EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.
PMID: 31681910 [PubMed]
PMCID: PMC6824726
EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.
PMID: 31528859 [PubMed]
PMCID: PMC6746603
EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?
PMID: 31276119 [PubMed]
PMCID: PMC6604646
EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.
PMID: 31406965 [PubMed]
PMCID: PMC6690616
EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.
PMID: 31517314 [PubMed]
PMCID: PMC6741290
EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.
PMID: 31633124 [PubMed]
PMCID: PMC6800226
EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.
PMID: 29662969 [PubMed]
PMCID: PMC5898812
EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.
PMID: 30215058 [PubMed]
PMCID: PMC6133268
News and Events
January Issue Release
We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.
Submission Deadline for Upcoming Issue
ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before February 13, 2023.
Certificate of Publication
ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.
Best Article of the Issue
Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.
Certifying for Review
ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.
Latest Articles
The latest articles will be updated immediately on the articles in press page of the respective journals.