Study of indications of hysterectomy among benign gynaecology cases
Indian Journal of Obstetrics and Gynecology Research
Objective: Prospective observational study of indications of hysterectomy and postoperative complications was done among benign gynaecology cases attending the outpatient department of Obstetrics and Gynaecology, Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi, UP, India. Materials and Methods: Those women attending the outpatient department of Obstetrics and Gynaecology, Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi, UP, India who had hysterectomy done were given
... one were given questionnaire to fill or member of health care team filled questionnaires on their behalf if they were illiterate. The study duration was from July 2011 to June 2016. We included only those patients in whom hysterectomy was done at less than 30 years of age and total abdominal hysterectomy was done. Patients were asked regarding indication of hysterectomy, their understanding of their illness, postoperative recovery and current problem. Results: Total of 45 women gave information about their hysterectomy and their current health and they were all married. The 25-30 years age women were 93% in this observational study, 84% were from low socioeconomic status. In our questionnaire survey 71% of cases of Total Abdominal Hysterectomy (TAH) was done for the complaint of vaginal discharge. These women disliked the wetness of their undergarments (even if mild); they thought it as a harbinger of some severe illness. Fibroid was second most common cause (15%) in our group followed by heavy menstrual bleeding, then abdominal pain and prolapse. The most important observation of this study is presenting complain of the patients in this study. It is remarkable that 71% of women were operated for persistent vaginal discharge, while in 51% it was persisting at the time of presentation. When they were examined they had physiological discharge from the vaginal wall. 8% patients had persistent granuloma, which was causing post coital bleeding and discharge, and was treated. 15 % patients complained dyspareunia although no pathological cause could be elicited. Last and the most important questions which was asked, whether women understood her illness? Why did she need operation? Was she told of the complications? Only 11% patients knew it (e.g. had fibroid). This is not surprising. Vaginal discharge and indication of hysterectomy was not discussed with them. They were probably not offered medical treatment. Whether it was due to ignorance or some other factor, we could not elicit. Conclusion: This study shows higher rate of hysterectomy among patients with vaginal discharge. Majority of these women did not have medical treatment for their complain of vaginal discharge. Most important feature is that, in spite of hysterectomy these women continued to have vaginal discharge, which could perhaps indicates that their hysterectomies were unnecessary and their discharges were physiological. Education to health care workers and gynaecological patients is of utmost importance.