A Clincopathological Correlation of Hysterectomies: A Hospital Based Surgical Audit

Abstract

Objectives: To determine correlation of clinical indication of hysterectomies with histological findings and association with age and parity

Study Design: Institution based cross sectional study

Place and Duration of Study: This study was conducted at the Lady Dufferin Hospital, Karachi, Pakistan from Jan. 2007 to Dec. 2009.

Sample size: 322

Sampling Technique: Non Probability Purposive sampling  

Materials and Methods: A structured standardized Proforma was used to collect data between Jan 2007 to Dec 2009 from the pathological laboratory data on surgical hysterectomies. The data comprised of clinical, physical and histological examination. The analysis was made on correlation of clinical indication of hysterectomies with histological findings and association with age and parity.

Main outcome measures: Correlation of Clinical Indications and histological findings on uterus (endometrium and myometrium), cervix and ovaries

Results: Three hundred twenty two abdominal hysterectomies were studied. Among the study subjects the mean + SD age was 42.36 + 6.36.Only 12 (3.7%) women were unmarried. Clinically the commonest indications were Leiomyoma in 167 (519%) and DUB 120 (37.7%). Ovarian mass was clinical indication in 4 (1.3%) cases. Histopathology revealed leiomyoma 149 (46.3%) as the commonest uterine pathology, followed by adenomyosis. Endometrim showed Chronic endometritis in 22 (6.9%) , hyperplasia in 10 (3.2%) and carcinoma in 2 (0.6%) cases. Inflammation with squamous metaplasia252 (78.2%) was the most common pathology noted in the cervix whereas Squamous Cell Carcinoma was seen in only 1 (0.3%).Most common finding in ovaries was Cystic follicles in 101(46.4%) , cystadenomas were noted in 6 (2.8%) and Benign teratoma in 3 (1.4%).

Conclusions: Hysterectomy is a major gynecological procedure therefore it should be performed after accurate clinical assessment and with proper and justified indications.