Abstract

Introduction: Hysterectomy is still a common gynaecological procedure that has undergone changes in indication and technique over recent decades. Data on hysterectomy practice must be up to date to reflect current trends and inform service planning and postgraduate training. The audit was undertaken to provide current data on hysterectomy for benign gynaecological conditions.
Methods: The Coombe hospital is a tertiary referral centre for gynaecological conditions with an electronic database of patients treated. All women who underwent hysterectomy for non-obstetric, non-oncological indications in 2024 were identified and their case notes examined by the study team. A dedicated study database was created and the results analysed.
Results: There were 216 cases that satisfied the inclusion criteria. There were 54.2% in the 45-64 age group and 37.5% had a BMI more than 30. Laparoscopy was used in 50.6% of cases and 50% were performed for prolapse and fibroids. Vaginal hysterectomy was usually performed for prolapse in older women (median age 66.9y)and was associated with an anterior/posterior colporrhaphy in 88.7% of cases. Vaginal hysterectomy patients had a significantly smaller perioperative haemoglobin drop (1.2g/dL) and shorter post-operative hospital stay (median 2.3d). There were 3(1.4%) cases of malignancy and 2 were unsuspected preoperatively.
Conclusion: This audit demonstrates the need for the continued service provision of laparoscopic services and the necessity to continue training in vaginal hysterectomy and pelvic floor surgery.

Keywords

hysterectomy, indication, abdominal, vaginal, laparoscopic