Gynecological Endoscopic Procedures in a Tertiary Hospital in South‑West Nigeria: A Prospective Study

Abstract

Background: After several years of struggling due to many constraints, centers in Nigeria are now performing Gynecological Endoscopy (GE) procedures. This study describes the outcome of various GE procedures in patients with gynecological complaints in a tertiary hospital in South‑West Nigeria. Materials and Methods: This study was a prospective longitudinal design. All eligible patients who had endoscopic procedures in the unit between May 2014 and April 2019 were recruited. Excluded were those who refused to take part in the study. The participants were followed up for a year. Data were collected during the preoperative, intraoperative, and postoperative periods. This data included the patient’s sociodemographic characteristics, indications for the procedures, procedures carried out, and the procedures’ outcome. Results: Of the 287 patients who had various procedures during this period, we recruited two hundred and seventy eligible patients (94.1%) for the study. We lost fourteen patients (5.2%) to follow up. One hundred and seventy‑two (63.7%) had laparoscopy only. Eighty (29.6%) had hysteroscopy and laparoscopy, while the remaining 20 (6.7%) had hysteroscopy only. Thirty‑eight (14.1%) were emergencies, while 125 (46.3%) were only diagnostic. Procedures carried out include hysteroscopic removal of missing intrauterine devices (6.3%) and laparoscopic tubal sterilization with Falope ring application (5.2%). We also carried out laparoscopic ovarian drilling for polycystic ovary syndrome (19.3%). Six patients (2.2%) had their surgery converted to laparotomy. We recorded no mortality. Conclusion: Our results showed the feasibility of GE surgery in Nigeria with an acceptable outcome. Local adaption and improvisation will ensure cost reduction and widespread use of these procedures in our setting.