Hysterectomy in the Present Day for Dysfunctional Uterine Bleeding: a finding from Tertiary Care Hospital Nepal

Abstract

Introduction: Hysterectomy is a an operative procedure in gynecology, performed for benign or malignant indication, accomplished via abdominal or vaginal routes, technically as open or endoscopic surgery by various approaches; laparoscopic, laparoscopic assisted vagina hysterectomy or robotic surgery. This study was undertaken to analyze the indications of hysterectomies for benign condition with main focus on dysfunctional uterine bleeding (DUB).

Method: This study was conducted between 2009 April and 2014 March in the Department of Obstetrics and Gynaecology Tribhuvan University Teaching Hospital. Data were obtained from Operation Theater. Results were precisely reevaluated to find out the indication of hysterectomy done for benign etiology, routes of surgery.

Results: Fibroid, utrovaginal prolapsed (UVP), adenomyosis, endometriosis, dysfunctional uterine bleeding (DUB) and adnexal mass were the main indication in total hysterectomy (n1644) performed for benign aetiopathologies, most surgery being performed abdominally (n1126). DUB which were principally treated by hysterectomy and occupied the fifth position as an indication had the postoperative diagnosis other than DUB on histopathological examination in more than 50%. The endometrial pathologies in the operated cases showed endometrial hyperplasia in three cases and adenocarcinoma in one.

Conclusion: Presently, abdominal hysterectomy is seen as the only available surgical option for DUB, indicating a need for a change in practices favoring organ preservation.