AN AUDIT OF CLINICOPATHOLOGICAL INDICATIONS OF ABDOMINAL HYSTERECTOMY

Abstract

Objective: To determine clinical indications of abdominal hysterectomy and compare these with histopathological diagnosis.

Study design: A descriptive study.

Methods: Case records of all the women that underwent major gynaecological operations in one calendar year period i.e. January to December, 2005 were reviewed. The cases that underwent total abdominal hysterectomy were selected and studied for the indications. All the patients had been admitted through the out patient department (OPD) for the complaints of irregular vaginal bleeding with or without pain and mass in lower abdomen.

Results: A total of 306 major gynaecological operations were carried out, of which 180 (58.81%) were abdominal hysterectomies. Majority of the women (65%) were between 35-45 years of age. The most frequent presenting symptom was pain and irregular vaginal bleeding (57.5%), irregular vaginal bleeding (25%) and mass in lower abdomen (7.2%). Disparity was found between clinical and histopathological diagnosis in cases of leiomyoma (36% clinical and 38.3% histopathological) and adenoma (11.1% clinical and 27.2% histothological). Clinical diagnosis of dysfunctional uterine bleeding was made in (26.1%) of which only 20% were confirmed histopathologicaly.

Conclusion: There was a disparity of 6 - 16% between clinical and histopathological diagnosis especially in cases of adenomas, dysfunctional uterine bleeding and lieomyoma. Therefore, accurate clinical assessment of cases should be the main stay of diagnosis and categorization for different indications of hysterectomy.