Abstract
Background: Total abdominal hysterectomy (TAH) is a common gynaecological operation and rarely obstetric. Indications for TAH may be benign or malignant and it is one of the most commonly performed surgical operations worldwide.
Aim: To describe the frequency, indications and complications of total abdominal hysterectomy (TAH) at a tertiary health institution in Abeokuta, Southwest Nigeria over a five-year period.
Methods: It was a 5-year descriptive retrospective study of all the total abdominal hysterectomies performed at our centre; a tertiary health institution in Abeokuta, Southwest Nigeria between January 2013 and December 2017. Case notes of 87 TAHs performed during the period were retrieved and analysed.
Results: There were 94 cases of TAHs out of a total of 515 major gynaecological surgeries during the period giving a TAH rate of 18.3% of major gynaecological surgeries. Eighty-seven (92.6%) of the case notes were retrieved for analysis. Average parity of the patients was 2.9. Uterine fibroid was the most common indication constituting 81.6% of all the cases. Intra-operative blood loss ranged from 300mls to 1600mls with an average of 553.44mls. Forty-four (50.6%) patients lost less than 500mls of blood. Post-operative anaemia in 35 (40.2%), and pyrexia in 11 (12.6%) patients were the most common complications.
Conclusion: Total abdominal hysterectomy is a common gynaecological procedure. It is indicated in both benign and malignant gynaecological conditions. Uterine fibroid was the most common indication. Post-operative anaemia and pyrexia were the most common complications. It is apparent that proper optimization of patients prior to surgery is necessary to prevent post-operative anaemia.
Keywords: Pattern, Gynaecological, Total abdominal Hysterectomy, Indications, Complications.
References
- Hammer A, Rositch AF, Kahlert J, Patti E. Gravitt PE, Blaakaer J, et al. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates. AJOG, 2015: 213(1); 23-29
- Mukhopadhaya N, Manyonda IT. The hysterectomy story in the United Kingdom. J Midlife Health. 2013; 4(1): 40–41
- Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA. Hysterectomy surveillance—United States, 1994-1999. MMWR CDC Surveill Summ. 2002;51:1-8
- Stang A, Merrill RM, Kuss O. Hysterectomy in Germany: a DRG-based nationwide analysis, 2005-2006. Dtsch Arztebl Int. 2011;108(30):508-14.
- Stankiewicz A; L. Pogany L; Popadiuk C. Prevalence of self-reported hysterectomy among Canadian women, 2000/2001–2008. Public health agency of Canada. 2014:34(1)
- Arowojolu AO. Hysterectomy. In: Okonofua F, Odunsi K (ed.). Contemporary Obstetrics and Gynaecology for Developing Countries. Benin City. Women’s Health and Action Research Centre. 2003: 227 – 242
- Rabiu A, Habib R. Elective abdominal hysterectomy: Appraisal of indications and complications at Aminu Kano Teaching Hospital - An 8-year review. Trop J Obstet Gynaecol. 2017;34:224-8
- Oseki C, Osaikhuwuomwan JA. A Review of indications and outcome of total abdominal hysterectomy at a tertiary public health facility in Southern Nigeria. N Niger J Clin Res 2018;7:21-4
- Bukar M, Audu BM, Yahaya UR, Hysterectomy for benign gynaecological conditions at Gombe, north eastern Nigeria. Niger Med J. 200;51:35-8.
- Anzaku AS, Musa J. Total abdominal hysterectomy for benign gynaecological conditions at a University Teaching Hospital in Nigeria. Niger J Med. 2012; 326-330
- Wright JD, Herzog TJ, Tsui J, Ananth CD, Lewin SN, Yu-Shiang Lu et al. Nationwide Trends in the Performance of Inpatient Hysterectomy in the United States. Obstet Gynecol. 2013;122(2 0 1):233–241
- Usman HA, Sanusi IM, Kullima AA, Kawuwa MB. Hysterectomy for Gynaecological Conditions AtNguru, North Eastern Nigeria: A Retrospective Study. J. Med SciCli Res. 2012: 5(1); 17131-17138
- Koledade AK, Oguntayo AO, Zayyan MS, Avidime S. Samaila MO, Adesiyun AG. Hysterectomies pattern a a tertiary healthcare center, northern Nigeria. Trop J Obstet Gynaecol 2018;35:184-7
- Ikechebelu JI, Mbamara SU, Ezike HA. Laparoscopically assisted vaginal hysterectomy in southeast Nigeria-case report. Niger J Med. 2009;18:107–9.
- Olusegun O. Badejoko KO, Babawale OO and Adebanjo BA. Total laparoscopic hysterectomy: A case report from ILE-IFE, Nigeria. Niger Med J. 2012; 53(4): 254–256.
- Akintobi A, Bello O, Asaolu O. Ikena G, Adebayo A. Laparoscopic supracervical hysterectomy and uterine morcellation: A case report from Asokoro District Hospital, Abuja,
- Gante I, Medeiros-Borges C, Águas F. Hysterectomies in Portugal (2000-2014): What has changed? Eur J Obstet Gynecol Reprod Biol. 2017;208:97-102.
- Desai S, Shuka A, Nambiar D, Ved R. Patterns of hysterectomy in India: a national and state‐level analysis of the Fourth National Family Health Survey (2015–2016). BJOG. 2019126(4): 72–8
- Obilahi-Abhulimen, Ibrahim IA., Barry OO. Hysterectomy in the Niger Delta of Nigeria: A Clinical Study of Indications and Outcome. Greener J Med Sci. 2013: 3 (5); 160-165,
- Abisowo, O. Y., Olusegun, F. A., Ireti, A. O., Adeniyi, O. I., & Oyedokun, O. Y. Hysterectomy in a Southwestern Tertiary Unit in Nigeria: A 5-Year Review. J Gynecologic Surgery, 2016; 32(6), 335–338.
- Rositch AF, Nowak RG, Gravitt PE. Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009. Cancer 2014; 120:2032-8
Corresponding Author
Olaide R. Adenaya
Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.56
