مرکز منطقه ای اطلاع رساني علوم و فناوري - Hysterectomy indications and distribution of histopathological diagnoses

Abstract :

Aim. Examine the clinical indications for hysterectomy operations performed in our clinic and put forward the histopathologic diagnosis of hysterectomy materials. Method. 223 total abdominal hysterectomy cases performed between January 2010-January 2013 were retrospectively evaluated. Age, menopausal status, operation indication, the operation data and the results of materials pathological examination were analyzed. Results. The mean age of the patients was 49.3±5.4. All cases underwent total abdominal hysterectomy. 76.2% of the patients was performed bilateral oopherectomy, 17.4% of the patients was performed unilateral oopherectomy, 6.2% of the patients was performed only hysterectomy. Between the hysterectomy indications the most common one was leiyomyom with 138 patients (61.8 %). The other indications were dysfunctional uterine bleeding with 38 patients (17%), adnexal masses with 37 patients (16.5%), pelvic organ prolapse with 10 patients (4.4%). As the result of histopathological examinations of hysterectomy materials, the most common pathologies are defined as leiomyom, adenomyosis, and ovarian/paraovarian cyst with the rates 68.1%, 37.2%, 18.8%, respectively. The most common combination was leiomyom and adenomyosis combination with the ratio of 15.2%. In addition, 19 patients (8.5%) were determined with endometrial polyps, 15 patients (6.7%) with endometrial hyperplasia, 11 patients (4.9%) with atrophic endometrium, 4 patients (1.7%) with cervical intraepithelial neoplasia, 3 patients (1.3%) with endometrial cancer. Conclusion. In our study, the most common indication of hysterectomy was uterine myoma as the literature. The most common histopathological examination result was leiomyom and adenomyosis. Adenomyosis must be kept in mind in patients who consulted with complaint of menometrorrhagia/ pelvic pain and especially having myoma. Hysterectomy is the most preferred choice in treatment of pelvic pain and also myomas causing menometrorrhagia in perimenopausal with no further desire of childbearing and postmenopausal women.