Case records and commentaries
Background: Hysterectomy is one of the commonest major gynaeeological operations worldwide, and has become one of the most controversial surgical procedures especially with regard to its indications, which have varied widely. At Consolata hospital, during the study period, it accounted for 65% of the elective gynaecological operations. Objective: To determine, the characteristics of patients who underwent hysterectomy at a peri-urban mission hospital. Study design: Retrospective descriptive study. Setting: Consolata Hospital Nyeri, Gynaecological ward Study materials: Records of all hysterectomies performed between 1st Mareh 1999 and 28th February 2003 (4 year period). Main outcome measures: Indications, types, and outcomes of hysterectomies performed at Consolata Hospital, Nyeri. Methodology: All the necessary information obtained usmg a data collection tool was computed, analysed, and tabulated. Results: During the study period there were 177 hysterectomies performed at Consolata Hospital Nyeri. Majority (77.8%) of the patients were in the age bracket 0[31-50 years with the mean age of 43.2 years and ranging between 22-75 years. Nearly all were parous (97.5%), with 77.3% being married. 131 (74%) hysterectomies were done due to symptomatic uterine fibroids; 22(12.4%) were due to recurrent abnormal uterine bleeding; while 13(7.3%) were due to malignancy of the ovary, uterus, and cervix. Obstetric complications were the indications in 2( 1.1%) patients. 98.9% of the hysterectomies were elective, 97.2% were performed through the abdominal route, and 97.2% were performed under general anaesthesia of the ahdominal hysterectomies, t 72(97.2%) were total and 4(2.3%) were subtotal hysterectomies. Only 17(9.6%) patients had a Pap smear done prior to surgery; while 133(75.1%) had ultrasonography and more than 99% had heamatological evaluation. There were only 3(1.8%) intra-operative, and t I(6.2%) postoperative complications; with a 1.1 %( 2 patients) mortality. 81.9% of the hysterectomies were histopathologically verified. Uterine fibroids (Leiomyomata) were verified in 93.8% of cases.