Hysterectomy in a Southwestern Tertiary Unit in Nigeria: A 5-Year Review

Abstract

Background: Hysterectomy is one of the commonest major gynecologic surgeries performed worldwide. While the procedure is highly successful for curing diseases, especially nonmalignant conditions, it is not without risks. Objective: The aim of this research was to review hysterectomies in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria, with respect to indications, types, outcomes, and complications over a 5-year period. Materials and Methods: This was a descriptive retrospective study conducted from January 1, 2005 to December 31, 2009. Case records of patients who underwent hysterectomy were retrieved to obtain information on sociodemographics, types of hysterectomy, elective or emergency surgeries, blood losses, blood units transfused, and surgical complications. Results: Of 1859 major gynecologic surgeries during the study period, there were 196 hysterectomies, an incidence of 10.5%. Mean ages of the patients were 46.83 ± 9.18 years (elective surgery) and 40.28 ± 6.82 years (emergency surgery). Mean parity was 3.67 ± 2.06 for elective surgery and 3.86 ± 0.9 for emergency surgery. Uterine fibroid was the commonest indication at 61.44%, followed by ovarian mass at 7.84%. Mean blood loss was higher (3510 ± 1384) mL in emergency surgery, compared to (886.6 ± 587) mL in elective surgery (p = 0.023). Thus, the mean unit of blood transfusion was 6.57 ± 2.23 units in emergency surgery versus 1.82 ± 2.0 units in elective surgery (p = 0.031). Complications included hemorrhage at 8.3%, urinary tract infection at 3.5%, wound infection at 2.1% and intestinal obstruction at 0.7%. Three death (1.8%) were all attributed to severe hemorrhage. Conclusions: To achieve the most favorable outcome, appropriateness of the surgery must be evaluated carefully along with available options in the context of the patient's disease process. (J GYNECOL SURG 32:335)