ELECTIVE ABDOMINAL HYSTERECTOMY: INDICATIIONS AND COMPLICATIONS IN ENUGU, EASTERN NIGERIA.

Abstract

A six-year review of hysterectomies at the University of Nigeria Teaching Hospital, Enugu, Nigeria, was undertaken to determine the rate, indications and complications of the operation. There were 14 hysterectomies per 100 gynaecological in-patients. In a decreasing order of frequency, the main indications for the 199 elective abdominal hysterectomies during the study period were: uterine fibroids (66.7%), ovarian tumour (12.1%) and cervical malignancy (11.6%). The sub-umbilical midline incision was used in 166 (83.4%) of the cases. Moderate to severe intra-pelvic adhesions were found in 59 (29.6%) of the patients. The uterine size was greater than 12 weeks gestation in 133 (66.8%) of the women. Appendicectomy was the most frequent incidental operation; it was performed on 56 (28.1%) of the subjects. Complications were recorded in 55 women, a complication rate of 27.6%. Approximately two-thirds of the complications involved the urinary tract or the abdominal incision wound. We conclude that although the hysterectomy rate in Enugu, Nigeria, is lower than in advanced countries, the indications and complications of the operation are similar to those from the latter countries. Suggestions are offered on how to minimise complications during hysterectomies.


Key words: Abdominal hysterectomy, indications, complications, Enugu.


(Global J Med Sci: 2002 1(1): 49-53)