Trend of hysterectomy: A retrospective analysis in Regional Institute of Medical Sciences (RIMS)

Abstract

Background: Hysterectomy is the second most common operation done in women next only to cesarean delivery. Trend of hysterectomy has changed over times with development of newer ideas, techniques, etc. An attempt has been made to study it and to assess the current scenario. Aims: To review and analyze cases of hysterectomy with a view to suggest ways of improving health care. Materials and Methods: A retrospective study was conducted from January 2007 to August 2011 which included 1,285 cases of hysterectomy. Parameters like age, parity, indication, procedure were analyzed and data was presented in percentages and proportions. To avoid biased result, emergency and routine cases were analyzed separately. Result: Most women were of more than 45 years of age in planned cases and between 20 to 45 years in emergency cases. Uterine fibroid was the commonest indication (40.7%). Obstetrical complications were the main cause for emergency hysterectomies. The most common procedure was total abdominal hysterectomy but in emergencies, subtotal hysterectomy was the procedure of choice. The rate of vaginal hysterectomy was 10.7%. Ovaries were preserved in 12.7%. Conclusion: Hysterectomy is usually postponed till 45 yrs of age in planned cases. Uterine myoma is the most common pathology in planned procedure. In emergency, the indication varies. Abdominal route is still the preferred by most gynecologists. The rates of vaginal hysterectomy and preservation of ovaries are much lower than desired.