GYNAECOLOGICAL HYSTERECTOMY;

Objective: To audit indications and outcome of hysterectomies in Fatima HospitalBaqai Medical University Karachi so as to improve the quality of care provided to patients. StudyDesign: Descriptive observational study. Place and Duration of Study: Department ofObstetrics and Gynaecology, Fatima hospital, Baqai Medical University Karachi from November2009 to November 2011. Patients and Methods: All patients undergoing hysterectomy forgynaecological conditions from 2009 to 2011were included in the study. Results:Hysterectomies for gynaecological conditions accounted for184 cases during the study period.Mean age of patient was 49 (range 30-60 years). Mean parity was 6 (range 0-11). The mostcommon indication for hysterectomy was fibroid uterus56(30.4%) cases, dysfunctional uterinebleeding 38 (20.6%) cases, and uterovaginal prolapse 10 (5.4%) cases. Abdominal hysterectomyaccounted for 174(96.6%) and vaginal hysterectomy accounted for 10 (5.4%) cases. Twenty six(14%) patients were found to be suffering from hypertension,6(3.3%)patients were suffering fromdiabetes mellitus. Wound infection occurred in 11 (6%) cases. No mortality was associated withhysterectomy during the study period. The duration of hospital stay was less in vaginal route ascompared to abdominal. Conclusions: An audit should be carried out every year to improve thelevel of care of patients and also the expertise of surgeon should be checked. The study hasshown that hysterectomy is a safe procedure but the high morbidity associated with thisprocedure is bothersome. The other options like endometrial ablation, intrauterine hormonaldevice like mirenaetc should also be considered. More efforts should be made on vaginalhysterectomies as it is economical and morbidity is less with it.