Justification rate for non-obstetric hysterectomies: a study of cases in University of Calabar Teaching Hospital,...

Hysterectomy is a commonly performed major, non obstetric operation. It is often the definitive treatment for several pelvic pathologies like uterine myoma, utero-vaginal prolapsed, dysfunctional uterine bleeding, cervical malignancy and uncontrollable post partum haemorhage. The use of the hysterectomy in women sometimes without disease has led to the perception that some of the indications for hysterectomy are unjustified. The aim of this study is to determine the justification rate for the procedure in the University of Calabar Teaching Hospital, Calabar.

This was a retrospective study of hysterectomies done at the University of Calabar Teaching Hospital between January 2001 and December 2005. The preoperative indication was compared with the pathologist's report after surgery. Hysterectomy was considered justified if the pathology report verified the indication for surgery or showed a significant alternative pathology.

The indication for hysterectomy corresponded with the histopathological diagnosis in 76.7% of cases, while in 23.3% cases the indication and histopathological diagnosis did not correspond, out of these 3.3% of cases had significant alternative pathology. In this study 80% of all hysterectomies were justified while it was not justified in 20% of cases.

It is suggested that guidelines aimed at reducing unnecessary hysterctomies should be put in place and implemented. This will go a long way in improving the justification rate for hysterectomies at our centre, save clients resources, improve client satisfaction and quality of care.