Abstract
Objective: To determine the incidence, indications and outcome of hysterectomy in Nguru, a reference center in Northeast Nigeria.
Design: Retrospective cohort study
Setting: Federal medical center Nguru, Northeast Nigeria.
Population: All cases of hysterectomy for gynaecological indications
Methods: This study is a descriptive analysis of cases of gynaecological hysterectomies performed over a 5 year period (1st January, 2010-31st December 2014). Information on socio-demographic characteristics, indication for and type of hysterectomy, intra and post-operative morbidities including the need for blood transfusion, cadre of surgeon and duration of hospital stay were retrieved and analyzed.
Main outcome measured: The commonest indications, route of hysterectomy, and complications in relation to the experience of the gynaecologist.
Results: Elective hysterectomy for gynaecological conditions accounted for 25% of all major gynaecological operations during the period of study. Abdominal to vaginal hysterectomy ratio is 5.6: 1 with 56 (84.8%) abdominal and 10 (15.2%) vaginal hysterectomies. Hysterectomy on account of uterine fibroid was the commonest indication seen in 40 (60.6%) of the abdominal hysterectomies while all the 10 vaginal hysterectomies were on account of utero-vaginal prolapse. Majority 41(62.1%) had bilateral salpingo-oophorectomy. The age range was between 20 and 76 years while the parity was between 0 and 14.There was no statistically significant difference between the age of the subjects and the indications for the hysterectomy (P=0.66).However, there was statistically significant difference between the type of hysterectomy (abdominal or vaginal) and the morbidity rate (P=0.009).The overall morbidity rate in this review was 17(25.8%) with haemorrhage accounting for most (n=10; 59%) of the total morbidities. Fifty per cent (50%) of the morbidity in the vaginal route were urinary tract injuries. There was no mortality directly related to hysterectomy .during the period of the study.
Conclusion: Hysterectomy is a common major Gynaecological surgery in this center and the common indications are uterine fibroid and utero-vaginal prolapse. It is a relatively safe procedure. However, it is apparent from this study that there is need to train resident doctors on vaginal hysterectomy to minimize complications of bladder and ureteric injuries seen with vaginal hysterectomy in this study.
Keywords: Hysterectomy, Gynaecological condition, indication, Morbidities
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DOI: https://dx.doi.org/10.18535/jmscr/v5i1.143
