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Orient Journal of Medicine

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A Review of Gynaecological Hysterectomies in a Private Specialist Hospital in Nigeria

CI Okafor, U Ukanwa, ME Nwankwo, CO Ezeigwe

Abstract


Background: Hysterectomy, the removal of the uterus, is practised worldwide. It is a major surgery, which may lead to significant morbidity or even mortality, hence, there must be a justifiable indication before the procedure is undertaken. Symptomatic fibroids and utero-vaginal prolapse are common indications in this environment.
Objective: To audit the 30 consecutive gynaecological hysterectomies done in our centre from January 2003 to July 2009, with a view to determining the demographic factors, indications, types of hysterectomies done, and morbidity/mortality associated with the procedures.
Methodology: This is a retrospective descriptive study. Data concerning these 30 patients were retrieved from the theatre records and their case notes. The analysis was done using simple tables and percentages.
Results: Hysterectomies accounted for 30(28.0%) of 107 major gynaecological operations done during the period under review. Of the 30 hysterectomies 11(36.7%) were vaginal hysterectomies, while total and subtotal abdominal hysterectomies accounted for 13(43.3%) and 6(20%), respectively. Bilateral salpingo-oophorectomy was done in 4(13.3%) patients. The most common indication was uterine fibroids 16(53.3%) followed by utero-vaginal prolapse 8(26.7%). The most common age range of the patients was 40-49year group 16(53.3%), mean age was 45.5±6.7. The most common parity group was para 5-8(53.3%). On the average, the vaginal hysterectomy patients needed less diclofenac injections for pain relief. One bladder injury was encountered. There was no mortality.
Conclusion: The indications for, and surgical outcome following gynaecological hysterectomy in a private specialist hospital, is comparable to that from public hospitals. The private hospitals should be considered in manpower development to help improve gynaecological practice.



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