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