Publication:

Two-year surgical review of elective hysterectomy for non-oncological indications: experience from a tertiary centre

Background This retrospective descriptive cross-sectional study was aimed at determining indications, surgical outcomes, complications and challenges of elective non-oncological hysterectomies performed at a tertiary referral centre over a 2-year period (1st December 2018 to 31st December 2019).

Methods With ethical approval, the medical records of all eligible women were retrieved, reviewed and analyzed. Measures of central tendencies, frequencies and percentages were used to compute the variables.

Results During the 2-year study period, a total of 245 elective non-oncological hysterectomies were performed. The age of the women ranged from 33 to 80 years with a mean age of 49.08 years; [standard deviation (SD): 8.88]. Women in the 40-49 year-old-age group constituted the majority 55.51% (n=136/245). Main indications were multinodular fibroid uterus (without menorrhagia), fibroid uterus with menorrhagia and genital prolapse. There was no case of laparoscopic hysterectomy. Majority (98.78%; n=242/245) of the hysterectomies were total hysterectomies. The commonest additional procedures performed was bilateral salpingo-oophorectomy (31.84%; n=78/245). Intra-operative complication rates were low: (0.40%; n=1/245) for bowel injury, bladder injury and bleeding from an ovary. Regional anaesthesia was the commonest type of anaesthesia (71.84%; n=176/245). The primary surgeon was above the level of a specialist in 99.19% (n=243/245) of cases.

Conclusions Most women had hysterectomy for non-oncological indications in their fourth and fifth decades of life on account of fibroid-related conditions and genital prolapse. There was no uptake of laparoscopic hysterectomy. Hysterectomies are generally safe in the hands of an experienced and skilled surgical team.