Publication:

Clinico-histopathological correlation of abdominal hysterectomy

Background Hysterectomy is the most common gynaecological procedure performed. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. It is still considered as the treatment of choice for benign lesion such as leiomyoma, adenomyosis, extensive pelvic infection or adhesions, dysfunctional uterine bleeding and obstetric complications. Objectives were to correlate the indications of abdominal hysterectomy to histopathological findings thus, determining histologically confirmed preoperative clinical diagnosis.

Methods This study was conducted at the department of obstetrics and gynaecology, Bangabandhu Sheikh Mujib medical university, Dhaka from August 2010 to January 2011. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.

Results One hundred patients undergoing abdominal hysterectomy were studied. Data were recorded on structured proforma, including demographic characteristics, clinical features and indications of the procedure. In. our study, it was observed that the most common clinical diagnosis was leiomyoma of uterus 52 (52%). Other clinical diagnosis was DUB in 30 cases (30%), adenomyosis in 7 cases (7%), endometriosis in 6 cases (6%). Pelvic inflammatory disease in 3 cases (3%), endometrial polyp (2%). Abdominal hysterectomy was the single approach done in these cases. Clinical, radiological as well as histopathology report correlated uterine leiomyoma very well and it was about 94.23%, while DUB was a disease of exclusion. In 53 cases combined pathology was found.

Conclusions Hysterectomy is currently the most widely performed major operation in gynaecology and histopathology is mandatory for ensuring diagnosis and management. With the improvement in the different organ preserving options, hysterectomy in benign disease should only be opted when all the other conservative options failure.