Indications, Complications and Outcomes of Hysterectomy at Korle Bu: A Five Year Review

Abstract

Background: Hysterectomy, the surgical removal of the uterus, is a frequently performed gynaecological surgical procedure worldwide. However, hysterectomy is associated with some complications and in a few instances fatal consequences. A woman after hysterectomy loses her reproductive ability, the ability to menstruate, in addition to a few minor complications and occasional major complications. Setting: This study was done at the department of Obstetrics and Gynaecology of the Korle bu Teaching Hospital (KBTH), in Accra, Ghana. Objective: The objective of the study was to determine the prevalence, complications and outcomes of hysterectomy at the KBTH from January 1, 2008 to December 31, 2012. Methods and materials: Study included all women who had hysterectomies at the department of Obstetrics and Gynaecology within the five year period. Data were collected with the help of a specially designed data capture sheet. Frequency tables and charts were used to summarize data. Stata version 11 was used to analyze data using Chi- square test, simple and multiple logistic regressions. Results: Over the five year period under review, a total of 2,090 hysterectomies were recorded. The prevalence of hysterectomy at the department was 7.8%. The leading indication for hysterectomy was uterine fibroids (67.3%). A total of 370 women had surgical complications. About 13% of cases had only one complication, 3% had two complications and 2% had three or more complications. More than half of Hysterectomy cases (69.1%) spent on average less than five days at the hospital after surgery. Hysterectomy was effective for symptom relief in 97% of cases. The risk of developing a surgical complication was reduced in hysterectomy for gynaecologic indications (aOR; 0.1; 95% CI (0.0-0.3); p-value<0.001) compared to hysterectomy for obstetric complications. Conclusions: Total abdominal hysterectomy was the predominant surgery at the department. Although hysterectomies were associated with some complications, the general outcomes of hysterectomy were favourable.