Audit of abdominal hysterectomy for benign disease: Indications and complications

Abstract

A retrospective study was conducted to evaluate the indications and complications of abdominal hysterectomy for non-malignant gynaecological conditions performed between 1st July 1992 and 30th June 1993. A total of 167 women underwent total abdominal hysterectomy during this period, of whom 127 (76%) were indicated for non-malignant conditions. The main indications were uterine leiomyomata (47.2%), pelvic endometriosis (15.7%) and benign ovarian tumours (15%). Oophorectomy was performed in 61.5% of patients. There was no mortality. The overall short-term complication rate was 59%, with febrile morbidity (33.9%) and haemorrhage requiring blood transfusion (17.3%) the most common complications. It was found that postoperative bladder drainage with Foley catheterisation in situ was associated with a significant increase in urinary tract infection. Prophylactic antibiotics and a vaginal drain did not decrease the febrile morbidity rate. The redivac drain was effective in reducing the wound complication rate. However, due to the small sample size and heterogeneous management, further study is required to clarify the validity of these observations.