IJCRR - Vol 07 Issue 10, May, 2015
HYSTERECTOMY: A CLINICOPATHOLOGICAL CORRRELATION
Author: V. Arunadevi
Category: General Sciences
Objectives: To correlate indications of hysterectomy with the histopathological findings, in order to determine the percentage of preoperative diagnosis that was confirmed on histopathology and to determine the frequency of unexpected pathologies.
Methods: A retrospective study of 200 patients who had elective hysterectomy performed for various indications during the study period from January 2014 to December 2014 was conducted.
Settings: Karpaga Vinayaga Institute of Medical Sciences and Research Institute.
Results: 97.5% of hysterectomies were done for benign indications. The most common pathology identified was Leiomyoma in 32% of cases. Hysterectomies done for UV prolapse showed atrophic endometrium in 62.7% of cases. Other less frequent pathologies identified included endometrial hyperplasia, disordered proliferative phase and endometrial polyps.
Conclusion: Histopathological analysis correlated well with preoperative clinical diagnosis for hysterectomy. Benign pathologies were more common than their malignant counterparts. The commonest indication and histological finding in our setting was leiomyoma. The clinical and pathological correlation is 91.8% in case of leiomyoma. Histological diagnosis is considered the definitive method of evaluating tumours.
Keywords: Leiomyoma, Adenomyosis, Hysterectomy
V. Arunadevi. HYSTERECTOMY: A CLINICOPATHOLOGICAL CORRRELATION International Journal of Current Research and Review. Vol 07 Issue 10, May, 51-54
1. Jocoby VL, Autry A, Jacobson G, et al Nation wide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol 2009: 114: 1041- 1048.
2. Babalola EO, Bharucha AE, Schleck CD, et al. Decreasing utilization of hysterectomy, a population based study in Olmsted country, Minnesota, 1965-2002. Am J obstetric Gynecol 2007; 196; 214, e1-7
.3. National Guideline Clearing house (NGC). Guideline synthesis; guidelines for determining the route of hysterectomy for benign conditions.
4. Laparoscopic techniques for hysterectomy. National Institute for Health and Clinical Excellence, November 2007.
5. Luesley DM. Obstetrics and Gynaecology. An Evidence – Based Text for MRCOG 2nd ed. Hodder Arnold, 09/2010; 571-2.
6. Whiteman MK ,Hillis SD, Jamieson D, et al. Inpatient hysterectomy surveillance in the united states, 2000-2004. Am J Obstet Gynecol 2008; 31-37.
7. Pinion SB, Parkin DE, Abramovich DR et al. Randomised trial of hysterectomy, endometrial laser ablation and transcervical resection for dysfunctional uterine bleeding .BMJ 1994; 309; 979-983.
8. Spilsbury K, Hammond I, Bulsara M, Semmens JB. Morbidity outcomes of 78, 577 hysterectomies for benign reasons over 23 years. BJOG 2008; 115; 1473-83.
9. Harkki – siren P, sjoberg J, Tiitinen A. Urinary tract injuries after hysterectomy. Obstet Gynecol 1998; 92, 113-118.
10. Roovers JP, van der Vaart CH, van der Bom JG, Heintz AP.Urinary incontinence after hysterectomy. Lancet 2000;356:2012-2013.
11. Tulandi T, Al-Shahrani A, Adhesion prevention in gynecologic surgery . Curr Opin Obstet Gynecol 2005;17:395-398.
12. Ellis H, Moran BJ, Thompson JN et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery; a retrospective cohort study. Lancet 1999;353;1476-1480.
13. Al-Sunaidi M, Tulandi T. Adhesion-related bowel obstruction after hysterectomy for benign conditions. Obstet Gynecol 2006;108:1162-1166.
14. Olsen MA, Higham-Kessler J, Yokoe DS, et al.Developing a risk stratification model for surgical site infection after abdominal hysterectomy. Infect Control Hosp Epidemiol 2009;30;1077-1083.
15. Marchionni M, Bracco GL, Checcuci V et al. The true incidence of vaginal vault prolapse: thirteen years experience, J Reprod Med 1999;44;679-684.
16. Unger JB, Paul R, Caldito G. Hysterectomy for the massive leiomyomatous uterus. Obstet Gynecol 2002;100:1271- 1275.
17. Studd J Hysterectomy A life saving as well as life enhancing operation. Menopause Int 2009; 15:2-3.
18. Lethaby A, Hickey M, Garry R, Penninx J. Endometrial resection / ablation techniques for having menstrual bleeding. Cochrane Database syst Rev 2009;CD001501.
19. A randomized trial of endometrial ablation versus hysterectomy for the treatment of dysfunctional uterine bleeding: outcome at four years. Aberdeen Endometrial Ablation Trials Group. Br J Obstet Gynaecol 1999;106:360-6.
20. Reich H, Ribeiro SC, Vidalia A. Hysterectomy as treatment for dysfunctional uterine bleeding. Baillieres Best Pract Res clin obstet Gynaecol 1999;13:257-67.
21. Ballard L, Lyon DS, Jones JL. Inpatients with menometrorrhagia : etiologies, treatments and outcomes. South Med J 2000;93:571-4.