A PROSPECTIVE STUDY OF HISTOPATHOLOGICAL OUTCOME OF PATIENTS UNDERGOING HYSTERECTOMY IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: The removal of the uterus is called hysterectomy. It is one of the common
operations performed on females and has mental, physical, social, economic, and psychosexual impacts, along with intra-operative and post-operative complications. Hysterectomy is the most common gynaecological surgical procedure after caesarean section. In India there is lower rate (4-6%) of hysterectomy has been reported, while there is higher frequency of hysterectomy (10- 20%) in developed countries. Over 600,000 hysterectomies were having been performed in US alone in 2003 according to reports, out of them 90% were performed for benign conditions.
Materials and methods: This was a Prospective observational study done in the Department of
obstetrics and gynaecology, Govt Medical College, Ananthapur from June 2023 to May 2024.
All the patients who had undergone abdominal hysterectomy and vaginal hysterectomy during the study period were included in the study. Hysterectomy done by other approach (VH or minimal invasive hysterectomy), hysterectomy done for malignancy and emergency
hysterectomy were excluded from the study. A detailed history, clinical examination and
imaging study were done for pre-operative diagnosis. Histopathological confirmation was done after surgery all data placed in table and were expressed in frequency and percentage.
Results: The age range was 30-75 years and the leading age group was 41-50 years. Majority
of the respondents were from rural areas 53% and 47% patients were from urban settings.
Among the subjects 74% were housewives and the rest 26% were service holders. Out of 78
cases clinically diagnosed as leiomyoma of the uterus, histopathology revealed leiomyoma in 76 cases, adenomyosis in 3 cases and chronic cervicitis in 2 case. Leiomyoma was associated with chronic. Cervicitis in 18 cases (25%), with adenomyosis in 7 cases (9.62 %), with CIN-I in 6
cases (7.69%) and associated with endometrial hyperplasia is 3 cases (3.77%) Conclusion: Hysterectomy is the commonest performed gynaecological surgery throughout the
world. Uterine leiomyomas are the most common solid pelvic tumours in women and they can
have serious adverse effects and impact on quality of life. As women postpone having children, gynaecologists will have to manage leiomyoma and polyps in a conservative manner. However, it is the responsibility of health care professionals to encourage teaching and implementation of alternative procedures to ensure that women receive the maximum benefits with least morbidity. Every hysterectomy specimen we subjected to histopathological examination histopathological analysis correlates well with the preoperative clinical diagnosis for hysterectomy. Histopathology is thus mandatory for confirming diagnosis and thus ensuring optimal management.