Non-emergency hysterectomy: why the aversion?

Abstract

To determine the influence of age and parity on consent for non-emergency hysterectomy in each of the indications, type of hysterectomy performed, and the difference in their outcomes. A 6-year prospective study of all cases of non-emergency hysterectomy at Aminu Kano Teaching Hospital, Kano, Nigeria. The data obtained were analysed using Epi-Info 3.2.2, 2004 statistical software. Chi-square test and exact probability test were used to determine significant associations. A P value of <0.05 was considered significant. Non-emergency hysterectomy accounted for 16.7% of all major gynaecological operations. The mean age of the women was 42.22 +/- 8.36 years, and mean parity was 5.84 +/- 3.24. Age and parity did not significantly influence respondents against giving consent for non-emergency hysterectomy in all the indications, except for age and uterine fibroids. The commonest indication was uterine fibroids (58.2%). There was a preference for abdominal hysterectomy. Post-operative complications were less with vaginal hysterectomy. The morbidity rate was 26.9% and there was no mortality. Non-emergency hysterectomy is a fairly safe procedure in Aminu Kano Teaching Hospital, Kano. Early marriage and childbearing significantly reduced the aversion to non-emergency hysterectomy. Increase in the use of vaginal hysterectomy where it is not contra-indicated should be encouraged in order to reduce the morbidity. Laparoscopic assisted vaginal hysterectomy will go a long way to achieve this goal when available in our unit. Efforts should be made to train gynaecologists in minimal access gynaecological surgeries.