Hysterectomy for uterine fibroids in Nullipara at Korle Bu Teaching Hospital, Ghana

  • Joseph D Seffah Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
  • Richard MK Adanu
Keywords: Ghanaian, nulliparous, fibroids, hysterectomy, litigation


Introduction: Uterine fibroids are common in Ghana and they constitute about 40%of the major gynaecological operations in Accra.

Objective: To determine the factors predisposing nullipara to hysterectomy
Design: A retrospective case-control study

Setting: The Korle Bu Teaching Hospital, Accra, Ghana between January 2002 and September 2003.

Method: A study of nullipara who had surgery for uterine fibroids. Data were extracted from operation records, patient clinical notes and histopathology reports. Comparisons were made using chi squared and t tests.

Results: Thirty eight hysterectomy cases and 52 myomectomy controls were studied. Only 3 (7.9%) of the hysterectomies were planned before surgery. The commonest reason for unsuccessful myomectomy was big uterine size and poor architecture. Hysterectomy cases were older (p<0.002) and had bigger uteri (p<0.001) than myomectomy controls. Complaints of abdominal distension (OR: 38) and menorrhagia (OR: 11.8) were the two factors that significantly increased the odds of hysterectomy.

Conclusion: A large proportion of nullipara scheduled for myomectomy could end up with a hysterectomy. Careful and detailed counseling before planned myomectomy is needed to prevent regret, litigation and major psychological trauma.

Keywords: Ghanaian, nulliparous, fibroids, hysterectomy, litigation

Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 125-128

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eISSN: 0189-5117