Publication:

Hysterectomy in uterine fibroids: an institutional survey pre and post COVID lockdown

Background The COVID-19 pandemic had a tremendous effect on surgical practice and surgical outcomes, especially in Gynaecology which had led to an increase in operative interferences like hysterectomies, which is one of the most frequently performed surgical procedures for uterine leiomyomas. Aim of this study was to determine the impact of covid lockdown on hysterectomies performed on AUB–L in perimenopausal and post-menopausal women based on clinical, radiological, and operative aspects.

Methods A retrospective study on perimenopausal and post-menopausal women who underwent hysterectomy for AUB-L was compared based on their clinical, radiological, and operative findings in the pre COVID period (April 2019-March 2020) and post COVID lockdown period of one year (July 2021-June 2022), at Department of Obstetrics and Gynaecology, SVS Hospital, Telangana.

Results The post-covid group has a significant increase in the severity of clinical symptoms such as menorrhagia and dysmenorrhea (VMSS-GRADE 2). Radiological findings (US AND MRI)-The size (>5cms) and number (>2) of fibroids increased significantly in post COVID group. The operative duration (1-3hrs), intraoperative blood loss (150-300ml), need for blood transfusion (>24%), postoperative pain (VAS pain score 5), and mean hospital stay (72-120hrs) were significantly increased in the post-COVID group as compared to pre COVID group attributable to delay in seeking medical advice due to COVID-19 lockdown.

Conclusions This study clearly states that the impact of the COVID-19 lockdown was significant in worsening clinical features, increasing the size and number of fibroids which in turn increased the number of hysterectomies, operative time and complications.