Evaluation of Preoperative and Postoperative Findings in Hysterectomy Cases for Benign Conditions
1University of Health Sciences Turkey, İstanbul Okmeydanı Training and Research Hospital, Clinic Obstetrics and Gynecology, İstanbul, Turkey
Eur Arch Med Res 2020; 36(1): 25-31 DOI: 10.4274/eamr.galenos.2019.58076
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Abstract

Objective: To evaluate the demographic patient characteristics, indications, operative findings, preoperative and postoperative histopathology reports in hysterectomies for benign conditions in our clinic.

Methods: One thousand four hundred seventeen patients who underwent hysterectomy for benign conditions were included in the study. Patient files and records from the Hospital Information Management system were reviewed. IBM SPSS Statistics 22 program was used for statistical analysis. Shapiro Wilks, One-way ANOVA, Tamhane’s, Kruskal-Wallis, Mann-Whitney U, chi-square and Fisher’s Exact test and Continuity (Yates) Correction were used as statistical tests. Statistical significance was defined as p<0.05.

Results: Mean age of the patients was 50.78±9.24, mean gravidity and parity were 4.09±2.56 and 3.06±1.96, respectively. History of gynecological surgery, cesarean section and non-gynecological abdominal surgery were 26.7%, 17.1%, and 11.2%, respectively. The most common indication was uterine myoma with 43%, 78.3% of the patients had abdominal, 14.3% had vaginal, 6.5% had laparoscopic hysterectomy. Complications occurred in 5.4% of the cases; major in 3.2% and minor in 2.2%. Patient age, gravidity and parity in vaginal hysterectomy cases were higher. The rate of cesarean section history (28.9%) in the group with subtotal hysterectomy was significantly higher than the rate of cesarean section history (16.3%) in the group with total hysterectomy. Postoperative histopathology results were reported as leiomyoma in 53.6% and adenomyosis in 23.1%.

Conclusion: Hysterectomy is the most commonly performed gynecological operation. It may be done abdominally, vaginally or laparoscopically. The most common indication for hysterectomy is symptomatic uterine myomas. The preferred route of operation should be based on the charecteristics and findings of the patient. If there is no contraindication, vaginal hysterectomy should be the preferred operation type.