Evaluation of indications of hysterectomy in Kosar Teaching Hospital

Abstract Background: Hysterectomy is the most common major obstetric gynecological operation. Objective: To evaluate indications of hysterectomy. Methods: Retrospective study of hysterectomies was performed in Kosar teaching hospital from 1995 till 1998, excluding cesarean hysterectomies. Findings: Of 369 hysterectomies, 96 cases (26%) were vaginal and 273 (74%) were abdominal. Indications for all vaginal hysterectomies were uterine prolapse. The most common symptom in abdominal hysterectomies was vaginal bleeding. Final pathologic reports in order of prevalence included: myoma, normal, adenomyosis, glandular hyperplasia, polyp, simple hyperplasia and cancer of endometrium. In almost half of the cases of TAH, preoperative indications were appropriate (49%). Of 51% of cases with inappropriate preoperative indications, 26% had pathology in uterus (E.g adenomyosis) and the remaining 25% had no organic lesion in final pathologic report. Positive and negative predictive values of clinical diagnoses were 0.75±0.04 and 0.49±0.05 respectively, (P=0.05). Conclusion: To prevent unnecessary hysterectomy, accurate preoperative evaluation, understanding of gynecologic pathology and knowledge of new alternative medical and surgical modalities are essential.