Research Article
Volume 10 Issue 10 - 2021
Prevalence, Indications and Surgical Outcomes in Gynaecological Hysterectomy for Benign Disorders at the Rivers State University Teaching Hospital, Port-Harcourt, Nigeria: A Six-Year Review
Peter A Awoyesuku*, Ngozi J Kwosah, Simeon C Amadi and Dickson H John
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Old G.R.A, Port-Harcourt, Nigeria
*Corresponding Author: Peter A Awoyesuku, Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Old G.R.A, Port-Harcourt, Nigeria.
Received: September 07, 2021; Published: September 22, 2021




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

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Citation: Peter A Awoyesuku., et al. “Prevalence, Indications and Surgical Outcomes in Gynaecological Hysterectomy for Benign Disorders at the Rivers State University Teaching Hospital, Port-Harcourt, Nigeria: A Six-Year Review”. EC Gynaecology 10.10 (2021): 92-105.

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