AN AUDIT OF GYNAECOLOGICAL HYSTERECTOMY AND UTEROVAGINAL PROLAPSE REVEALING A NEED FOR SAFE MOTHERHOOD

Abstract

Background: Hysterectomy is the major procedure performed abdominally/vaginally. Uterovaginal (UV) prolapse
is preventable but still common indication for Vaginal Hysterectomy (VH). The aim of this study was to compare
different aspects of abdominal and vaginal approach to hysterectomy and to find out frequency of prolapse.
Material & Methods: This cross sectional study was conducted at the department of obstetrics and gynaecology
at DHQ Teaching Hospital, D.I.Khan. The study was conducted from January 2013 to December 2014. Sampling
technique was purposive sampling. Sample size was 123. Information regarding socio-demographic characteristics
was noted. Indication for surgery, type of hysterectomy and post-operative morbidity and mortality were our
research variables. In patients with UV prolapse information about place of delivery and person who conducted
delivery was also recorded. Data collecting tools were charts/ register. Data was analyzed by using percentage
and frequency using SPSS.
Results: Within study period total gynecological admissions were 1693. 185 (11%) were major surgeries. 123
(66%) were hysterectomies. Average age was 50 years in VH and 52.5 years in Total Abdominal Hysterectomy
(TAH). The mean parity was 9 in VH and 4 in TAH, 48 (92%) Patients of VH were illiterate. While in TAH 30 (42.2%)
patients were illiterate.. Among indications prolapse was responsible for 44% of total hysterectomies and it was
only indication for VH. Complication rate of VH was 5.8% and TAH was 5.6%.
Conclusion: Most common indication was UV prolapse and most frequent procedure was abdominal hysterectomy.
UV prolapse is associated with large family size and home deliveries. Post-operative complications rate
difference was in significant in the two procedures.