Confirmation of the preoperative diagnosis for hysterectomy

ABSTRACT

This study was carried out in Gynaecology and Obstetrics department of Sir Ganga Ram Hospital, Lahore. The analysis of the case records and histopathology reports of 252 women, who underwent hysterectomy, was done. The objective of study was to determine the indications for hysterectomy in non-malignant diseases and to describe the indications where hysterectomy can be avoided or delayed. Out of 252 women included in the study. 175 had abdominal hysterectomy and 77 had vaginal hysterectomy. Fibroid uterus, dysfunctional uterine bleeding and uterovaginal prolapse were the major indications for hysterectomy. Forty-five percent of hysterectomies were performed for preoperative diagnosis that could potentially be confirmed by pathologic examination. Of these, in 88 percent the preoperative diagnoses were confirmed histologically. The pathologic report confirmed leiomyoma in 90.6 percent, endometrial hyperplasia 88.4 percent, adenomyosis 83 percent and cervical intraepithelial neoplasia in 100 percent cases. In remaining 55 percent of hysterectomies, indications were not potentially confirmable by the pathology. In 60.8 percent cases no pathology was detected, while 39 percent specimens revealed a pathology which was not diagnosed pre-operatively