GYNAECOLOGICAL HYSTERECTOMY;

AN AUDIT IN TERTIARY CARE HOSPITAL

Abstract

Objective: To audit indications and outcome of hysterectomies in Fatima Hospital
Baqai Medical University Karachi so as to improve the quality of care provided to patients. Study
Design: Descriptive observational study. Place and Duration of Study: Department of
Obstetrics and Gynaecology, Fatima hospital, Baqai Medical University Karachi from November
2009 to November 2011. Patients and Methods: All patients undergoing hysterectomy for
gynaecological conditions from 2009 to 2011were included in the study. Results:
Hysterectomies for gynaecological conditions accounted for184 cases during the study period.
Mean age of patient was 49 (range 30-60 years). Mean parity was 6 (range 0-11). The most
common indication for hysterectomy was fibroid uterus56(30.4%) cases, dysfunctional uterine
bleeding 38 (20.6%) cases, and uterovaginal prolapse 10 (5.4%) cases. Abdominal hysterectomy
accounted for 174(96.6%) and vaginal hysterectomy accounted for 10 (5.4%) cases. Twenty six
(14%) patients were found to be suffering from hypertension,6(3.3%)patients were suffering from
diabetes mellitus. Wound infection occurred in 11 (6%) cases. No mortality was associated with
hysterectomy during the study period. The duration of hospital stay was less in vaginal route as
compared to abdominal. Conclusions: An audit should be carried out every year to improve the
level of care of patients and also the expertise of surgeon should be checked. The study has
shown that hysterectomy is a safe procedure but the high morbidity associated with this
procedure is bothersome. The other options like endometrial ablation, intrauterine hormonal
device like mirenaetc should also be considered. More efforts should be made on vaginal
hysterectomies as it is economical and morbidity is less with it.