Incidence of Hysterectomy for Dysfunctional Uterine Bleeding with Post Tubal Ligation

Abstract

Background: Post tubal ligation syndrome has been a topic of debate and the association of Dysfunctional uterine bleeding (DUB) has been identified as a long-term complication. In refractory cases, hysterectomy can be considered a treatment option for managing the post-ligation syndrome due to prolonged menstrual complaints. But very few studies summarize the fact in our country's context. Considering of epidemiological data, the study was designed to assess the incidence of hysterectomy for DUB with post-tubal ligation. Methods: The hospital-based cross-sectional type of descriptive study was conducted in the inpatient Department of Gynae & Obst in Rajshahi Medical College Hospital (RMCH), From January 2019 to July 2019. Women suffering from DUB and having a history of post tubal ligation were included in the study. After selecting the patients, informed written consent was taken from the subjects. All patients were subjected to a detailed history, clinical examination, and relevant investigation. In necessary cases, hysterectomy was done as a treatment option. Data were collected using a semi-structured questionnaire designed for the study by the researcher. Data analysis and presentation were made by statistical software SPSS 23. Results: Total 100 patients with DUB were included in this study. The mean age was 40.9±6.28 SD (years), range: 25-54 years. The majority of patients (52%) belonged to the age group (41 – 50 years). About 59% came from rural areas. The mean parity was 3.43±1.34. The incidence of hysterectomy among DUB patients with a previous history of tubal ligation was 25%. The mean duration of tubal ligation was 13.4±6.3 years. The usual presentation per vaginal bleeding pattern at presentation was menorrhagia (47%), followed in second and third by metrorrhagia (20%) and postmenopausal bleeding (17%). Besides, 78% of patients also complained of tiredness, and 12% complained of pelvic pain. And Mean duration of symptoms was 13.44 months. Conclusion: About one-fourth of the tubal ligation patients underwent a hysterectomy in their subsequent life, and usually presented with menorrhagia. However, further studies are needed to finalize the incidence rate.