A Clinico-histopathological Correlation of Elective Abdominal Hysterectomy in a Tertiary Care Hospital of Bangladesh.

Abstract

Hysterectomy is the most common gynaecological surgery done in females worldwide as it provides definitive cure to wide range of gynaecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and pathology should be proved. Histopathological examination is essential to justify the appropriateness of the hysterectomy. The cross sectional descriptive type of observational study was carried out to correlate preoperative indications of abdominal hysterectomy with histopathological findings. This study was conducted in the department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020. The study included 100 women undergoing planned abdominal hysterectomy after fulfilling the inclusion and exclusion criteria by purposive sampling. Detailed information was obtained in each case regarding the history, clinical presentation, mode of diagnosis and histopathological report. Data were then classified, edited, coded and entered into the computer for statistical analysis by using SPSS Version 26.0 and presented in graph, pie chart and tabulated form. A total of 100 elective total abdominal hysterectomies were performed. Menorrhagia was the leading symptom (33.0%) followed by abdominal pain (20.0%). Leiomyoma was the most common pre-operative diagnosis (41.0%) followed by adenomyosis (20.0%). The most common histopathological diagnosis was leiomyoma (34) followed by adenomyosis (20.0%). Clinical and histopathological correlation was 100.0% in cases of ovarian tumor, complex endometrial atypical hyperplasia, pelvic inflammatory disease (PID), endometrial polyp and chronic cervicitis. Only 40.0% of preoperatively diagnosed postmenopausal bleeding cases were correlated histopathologically while the rest were missed preoperatively which included endometrial polyp (40.0%) and adult granulosa cell tumor (20.0%).