Total abdominal hysterectomy in a Tertiary Hospital in Kumasi: Indication, Histopathological Findings and Clinicopathological Correlation

Abstract

Hysterectomy is the commonest gynaecological surgery worldwide. Hysterectomy is commonly performed in our centre with request for post-surgical histological confirmation of pathologies. The aim of this study was to review all the hysterectomy specimens sent to our department between 2008 and 2016 and analyse the histological diagnosis in them and clinically correlate with the indications for the surgery. We reviewed retrospectively request forms, histological reports and slides generated for all cases of hysterectomies sent to our department for histological assessment between 2008 and 2016 totalling 1086. All the data obtained were analysed using SPSS 21. A total number of 1086 cases of hysterectomies with or without salpingooophorectomy were received in our department. The age range was 15 to 85 years with age group 40 to 49 years constituting 57.7% of cases. The commonest indication for surgery was uterine mass which constituted 722 cases (66.42%) and an obvious uterine mass was found at grossing in 737 cases (66.48%) while histology revealed uterine leiomyoma in 861 cases (79.28%) constituting the largest proportion of histological diagnosis. Other indications for surgery include dysfunctional uterine bleeding, suspected ovarian and cervical malignancy and peri-partum haemorrhage. Histological diagnoses confirmed wide range of lesions within the endometrium, cervix, fallopian tubes and ovaries. There was correlation between clinical indication and histological diagnosis up to 90.2% of all cases. Our data confirmed hysterectomy specimens with or without salpingo-oophorectomy as a common histological specimen in our laboratory, with peak age of patients in the fifth decade. Leiomyoma was the commonest histological finding and other wide ranges of pathologies were seen with strong positive (r = 0.98) correlation between pre-operative indication and the final diagnosis.

Journal of Medical and Biomedical Sciences (2018) 7(1), 22 - 28