Confirmation of the preoperative diagnosis for hysterectomy

This study was carried out in Gynecology and Obstetrics department of Sir Ganga Ram Hospital, Lahore. The analysis of the case records and histopathology reports of 252 women, who underwent hysterectomy, was done. The objective of study was to determine the indications for hysterectomy in non-malignant diseases and to describe the indications where hysterectomy can be avoided or delayed. Out of 252 women included in the study 175 had abdominal hysterectomy and 77 had vaginal hysterectomy. Fibroid uterus, dysfunctional uterine bleeding and utero vaginal prolapes were the major indications for hysterectomy. Forty-five percent of hysterectomies were performed by pathologic examination. Of these, in 88% the preoperative diagnosis that could potentially be confirmed leiomyoma in 90.6% endometrial hyperplasia 88.4%, denomyosis 83% and cervical intraepithelial neoplasia in 100% cases. In remaining 55% of hysterectomies, indications were not potentially confirmable by the pathology. In 60.8% cases no pathology was detected, while 39% specimens, revealed a pathology which was not diagnosed pre-operatively. (author)