A clinical audit of hysterectomy in Bowen University Teaching Hospital Ogbomoso, South West Nigeria

Abstract

Context: Hysterectomy is a major gynaecological surgical procedure which involves the removal of the uterus, occasionally structures in the adnexae are removed alongside depending on the need to do so. Hysterectomy can be approached Abdominally, vaginally or even with laparoscopic assistance. Objective: This study was embarked on to ascertain the prevalence, indication, pattern and outcome of hysterectomy over a four (4) year period. Study design, Settings and Subjects: This study is a four (4) year retrospective review of all cases of st hysterectomy either for gynaecological or obstetric reasons managed at BUTH from 1 January 2011 through 31st December 2014. Result: During the period under review a total of 127 hysterectomies were done for gynaecological and obstetrical indications, However, only 103 case records were available. Gynaecological indication was the reason for hysterectomy in 95 (92.2%) , while the remaining 8 (7.8%) had hysterectomy for Obstetrical indications. The mean age of patients in our study was 49.2±12.6 years; there was an age distribution of 18-90 years. The mean age of patients who had abdominal hysterectomy was 45.3±7.4 years, while the mean age for patients who had vaginal hysterectomy was 68.7±5.3 years. Abdominal hysterectomy accounted for 90(87.4%) , while vaginal hysterectomy accounted for the remaining 13(12.6%) ; there was no case of laparoscopically assisted vaginal hysterectomy done. There were three(3) deaths following emergency hysterectomy performed on account of primary postpartum haemorrhage. Conclusion: Hysterectomy remains a major gynaecological procedure. Necessary steps are needed to ensure that gynaecologist acquire skills for hysterectomy especially vaginal hysterectomy and even laparoscopic assisted hysterectomy.