Case records and commendaries
Abstract
Background: Hysterectomy is one of the commonest major gynaeeological operations
worldwide, and has become one of the most controversial surgical procedures especially
with regard to its indications, which have varied widely. At Consolata hospital, during the
study period, it accounted for 65% of the elective gynaecological operations.
Objective: To determine, the characteristics of patients who underwent hysterectomy at a
peri-urban mission hospital.
Study design: Retrospective descriptive study.
Setting: Consolata Hospital Nyeri, Gynaecological ward
Study materials: Records of all hysterectomies performed between 1st Mareh 1999 and
28th February 2003 (4 year period).
Main outcome measures: Indications, types, and outcomes of hysterectomies performed at
Consolata Hospital, Nyeri. ,.
Methodology: All the necessary information obtained usmg a data collection tool was
computed, analysed, and tabulated.
Results: During the study period there were ~177 hysterectomies performed at Consolata
Hospital Nyeri. Majority (77.8%) of the patients were in the age bracket 0[31-50 years with
the mean age of 43.2 years and ranging between 22-75 years. Nearly all were parous
(97.5%), with 77.3% being married. 131 (74%) hysterectomies were done due to
symptomatic uterine fibroids; 22(12.4%) were due to recurrent abnormal uterine bleeding;
while 13(7.3%) were due to malignancy of the ovary, uterus, and cervix. Obstetric
complications were the indications in 2( 1.1%) patients. 98.9% of the hysterectomies were
elective, 97.2% were performed through the abdominal route, and 97.2% were performed
under general anaesthesia. Of the ahdominal hysterectomies, t 72(97.2%) were total and
4(2.3%) were subtotal hysterectomies. Only 17(9.6%) patients had a Pap smear done prior to
surgery; while 133(75.1%) had ultrasonography and more than 99% had heamatological
evaluation. There were only 3(1.8%) intra-operative, and t I(6.2%) postoperative
complications; with a 1.1 %( 2 patients) mortality. 81.9% of the hysterectomies were
histopathologically verified. Uterine fibroids (Leiomyomata) were verified in 93.8% of
cases.
Citation
Master of Medicine (Obstetrics and Gynaecology) University of Nairobi, 2007Publisher
University of Nairobi, Department of Obstetrics & Gynaecology