Elective abdominal hysterectomy: Appraisal of indications and complications at Aminu Kano Teaching Hospital – An 8-year review

Abstract

Background: Hysterectomy is a safe and a major gynecological operation. It could be performed using abdominal, vaginal, or laparoscopic approach. It is performed for different indications such as dysfunctional uterine bleeding, endometriosis, fibroids, or prolapse. This procedure is however not without complications especially in resource‑poor countries. An overview of the outcome of the procedure is essential in facilities like ours that is located in resource‑poor countries. Objectives: To determine the rate, indications, and complications of elective abdominal hysterectomy at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Methodology: This was a retrospective study of all cases of elective abdominal hysterectomies performed over an 8‑year period (January 2009 to December 2016) at AKTH, Kano. Outcome measures were demographic characteristics, indication for surgery, type of hysterectomy, and postoperative complications. Results: During the period of study, there were 7632 major gynecological operations, among them were 251 cases of elective abdominal hysterectomy, giving a rate of 3.3%. The most common indication was uterine fibroid (51.8%). Total abdominal hysterectomy (TAH) was more commonly performed (93.0%) compared to subtotal hysterectomy (7.0%). Postoperative pyrexia (45.9%) was the most common complication, while ureteric injury (2.4%) was the least. Duration of hospital stay was 6–10 days in 89.2% of cases, and there was no mortality recorded. Conclusion: Elective abdominal hysterectomy is a fairly common and safe procedure in AKTH. Uterine fibroid and postoperative pyrexia was the most common indication and complication, respectively. TAH was commonly performed compared to subtotal hysterectomy. Keywords: Abdominal hysterectomy; complications; indications; Kano