Trends of hysterectomy in the rural tertiary level teaching hospitals in Northern India
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The aim of this study is to analyze indications, type and complications of hysterectomies done in the two rural tertiary level teaching institutes in Northern India.
Materials and Methods
It was a retrospective study in which the detailed analysis of demographic data of the patients, surgical indications, route of surgery and complications of the patients undergoing hysterectomy in one year (January 2015-December 2015) in Mayo Institute of Medical Sciences and Hind Institute of Medical Sciences in Barabanki, Uttar Pradesh, India was done.
Out of the total 157 cases of hysterectomy performed in two institutes, the incidence of vaginal hysterectomy was significantly higher (69.43% vs 30.57%, p<0.05) as compared to the abdominal hysterectomy. Pelvic organ prolapse was the most common indication for hysterectomy in the study group. Fibroid uterus, dysfunctional uterine bleeding, ovarian mass, chronic pelvic inflammatory disease and cervical intraepithelial neoplasia were the other indications. Hemorrhage during abdominal hysterectomy was the most common complication encountered (n= 6, 3.82%).
Lack of equipment's and technical support, unawareness of the patient, and financial constraints are the major factors leading to hysterectomy rather than resorting to minimal invasive techniques for benign gynecological complains. Moreover, the incidence of pelvic organ prolapse in the rural population should be reduced by promoting institutional deliveries, awareness about the benefits of adequate post-partum rest and nutrition, and effective contraception to avoid repeated child births. This will further help in reducing the rate of hysterectomy in rural population.
Hysterectomy, Vaginal route, Pelvic organ prolapse.