The case records and commentaries in obstetrics and gynaecology

Abstract

Objective: To evaluate surgical treatment of Mission Hospital. Methods: A descriptive retrospective analysis of 384 hysterectomies that were performed at St.Mary's Mission Hospital between 1st January and 31st December 2004 was undertaken. Main outcome measures: Indications for hysterectomy, types of hysterectomies, pre-operative investigations, intra-operative and post-operative complications, histo-pathological findings and validation of hysterectomy indication by histo-pathological confirmation. the use of hysterectomy gynaecological conditions as a mode of at St. Mary's Results: Out of the 384 hysterectomies done about 66% (n=253) -weredue to symptomatic uterine fibroids, about 10% (n=38)were due to adnexal masses and about 6% (n=25)were due to cancer of the cervix. Hysterectomies were performed abdominally in about 99% (380/384) of the cases, while about 1% (4/384) were done vaginally. Of the abdominal hysterectomies, about 79% (303/380) were total abdominal hysterectomies, about 10% (40/380)were subtotal hysterectomies, and about 9% (37/380) were extended hysterectomies. Only about 4% (16/351) of patients had a Papanicolaou smear prior to surgery. Of the 384 patients, about 1% (n=5) and 4% (n=17) had a peri-operative and post-operative complication respectively.Of the 348 hysterectomies performed for histologically verifiable indications, about 85% (297/348) were validated. Conclusion: Hysterectomy as a mode of surgical treatment for gynaecological conditions at St. Mary's Mission Hospital was justified as the morbidity and mortality were within international figures and the operative indications were validated inmajority of the cases