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An audit of hysterectomy at the Lagos University Teaching Hospital, Lagos
Abstract
Context: Hysterectomy is a common major gynaecological operation in many nations of the world. Significant morbidities and death have been associated with the procedure.
Objective: To identify the indications, types and peri-operative events associated with hysterectomy in Lagos.
Study design: A retrospective study employing the use of a pre-structured questionnaire to extract information from the case records of patients who had hysterectomy at the Lagos University Teaching Hospital between January 1996 and September 2003.
Main outcome measures: Duration of surgery, length of hospital stay and blood transfusions.
Results: A total of 103 case records of hysterectomy patients were analyzed. The incidence of hysterectomy was 9.29% of all gynaecological operations. Most of the patients were married, multiparous {at least 4 children} professionals aged between 45-49 years. 84.5% of cases were for uterine fibroids while the commonest operation performed was
total abdominal hysterectomy with bilateral salpingo-oophorectomy (59.2%). The duration of surgery, units of blood transfused and length of stay in the hospital were significantly increased with cancer-associated indications. Absence of pelvic adhesions at surgery was significantly associated with a reduced risk of being transfused intra-operatively.
Conclusion: The trend in the indications for hysterectomy has remained largely unchanged over the last half century. Also the patterns of complications and morbidity following the conventional hysterectomy types have not varied much. Establishment of a national hysterectomy database will likely highlight areas of further training and skill acquisition in techniques of hysterectomy, reduce morbidities and improve the overall outcome of the procedure.
Key words: Audit, hysterectomy, fibroids, Lagos.
