Complication Spectrum of Hysterectomy: A Retrospective Cohort Study from a Tertiary Care Hospital
Arun Sanap, Neha Gangane, Medha Davile, Anusha Kamath, Shuchita Mundle, Anita YadavAbstract
Objectives:
The objective of this study was to investigate the complications of hysterectomy.
Materials and Methods:
This retrospective cohort study was conducted at Tertiary Care Hospital and Institute of National Importance in Central India, including 310 patients, to analyze the complications associated with the hysterectomy. Medical records were obtained, and the demographic details, associated co-morbidities, surgical details, including indication, timing, and route of hysterectomy, were noted. Intraoperative and postoperative complications were noted. The data were collected, entered into a spreadsheet, and analyzed using statistical methods.
Results:
Majority of the patients were in the 40–49 years (mean of 47 years) age group, parous, premenopausal (69.7%), with associated comorbidities such as hypertension, diabetes, and obesity. Vaginal route was the most common (48.4%), followed by the abdominal (38.7%) and laparoscopic routes. The most common indications were abnormal uterine bleeding (45.2%) and uterine prolapse (36.8%). The common intraoperative complications were hemorrhage of > 1000 ml (5.8%), bladder injury (1.3%), bowel injury (0.65%), and conversion to laparotomy. The common postoperative complications were fever, urinary tract infections, paralytic ileus, deep venous thrombosis, wound/vault infections, burst abdomen, and urinary fistula. The complication rate was higher in abdominal than laparoscopic and vaginal hysterectomy (VH), leading to prolonged stay in hospital and intensive care unit admissions.
Conclusion:
Although hysterectomy is a common procedure in gynecology, it is accompanied by complications. VH was the preferred route, with minimal complications. The data can be used for patient counseling, surgical planning, and deciding treatment costs.