Audit of hysterectomy for benign pelvic diseases

The purpose of the study was to determine the frequency, Indications, complications of different types of hysterectomies and correlation with age and parity of the patients who underwent hysterectomy for benign pelvic disease. This study was carried out at Gynae Unit-II Bolan Medical Complex Hospital Quetta from September 2004 to March. 2006 for 18 months. Chart review was conducted during the study period for all patients who had hysterectomies for benign pelvic disease. 210 hysterectomies were performed during the study period out of these 163 [77.62] hysterectomies were carried out by abdominal route. Vaginal route was opted in 47[22.38%]. of cases and all the patients were having utero vaginal prolapse. The ratio of Abdominal to Vaginal Hysterectomy was 3.8:1. Dysfunctional uterine hemorrhage was the commonest indication of abdominal hysterectomies 57 [27.14%] followed by chronic PID 50[23.80%] fibroid 36[17.14%]. Majority of cases of fibroid Were in low parity and prolapse in high parity group. Majority of patients 179 [85.23%] were more than 40 years of age and 120[57.14%] were para 7 and above. Most of the women undergoing hysterectomies were between the age group of 41-45 years 80 [38%]. Overall complication rate was 44.6% higher in abdominal than Vaginal hysterectomy These Included wound infection 23[10.95] paralytic ilieus 19[9%]. UTI 17[8%], unexplained fever 15 [7.14%], and DVT 5 [2.38%] DVT was common in obese and those reluctant to ambulate. it is concluded from the present study that Vaginal Hysterecomy is associated with less morbidity and complication therefore well experienced Gynecologist should encouraged the vaginal route over the abdominal. Every tertiary level hospital should have the facility of hysterosocopic procedures for management. of DUH and fibroid