Hysterectomy in Women 40 Years and less for Benign Conditions in NHS Trust Hospital
Dr Nusarat Inamdar*

*Correspondence to: Dr Nusarat Inamdar M.S(OBG), MRCOG (UK), University hospital , west midlands. UK.

Copyright

© 2024 Dr Nusarat Inamdar. This is an open access article distributed under the Creative Commons Attribution  License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 26 May 2024

Published: 01 June 2024

Introduction

Hysterectomy is defined as the surgical removal of the uterus or womb.About 1.2 million hysterectomies are done globally every year. It is estimated that 1 in 5 women will experience the operation at some point in their lives.

Different route of hysterectomy

• Abdominal hysterectomy (AH)
• Vaginal hysterectomy
• Laparoscopic hysterectomy that include total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy
• Subtotal hysterctomy

In England 12.7% of benign hysterectomies are performed on women under 40 years old.

Aim and objective

This study focuses on

  - Comparison of national hysterectomy rate to hysterectomy in UHB trust

   - Ethnicity

   - Identify indications of hysterectomy.

   - Histology

   - Conservative treatment offered  as per NICE guideline

   - Time gap between presentation to hysterectomy

Methodology

This was a study carried between : jan 2019 to dec 2022, all data was collected by Concerto.

Inclusion criteria : Hysterectomies done for women 40 yrs and less

Exclusion criteria : any precancerous or cancerous condition are not added.

Comparison of total hysterectomy and in women less or equal to 40 years in UHB to England.

Fig 1: Age group: women belonged to arrange group of 26 yrs to 40 yrs , mean age in women 35 years .

Ethnicity:

Fig 2: Most of the women belong to white British ethnicity.

Fig 3: This study showed that women belong the parous women.

Fig 4: This graph shows the symptoms at presentation to clinic .Most women presented with abdominal pain.

Fig 5: Most of women underwent ultrasound as part of initial investigation.

Fig 6: Different medical therapy offered as part of initial therapy before surgery was offered.

Fig 7: Time from first presentation to surgery

Fig 8: Diagnosis before surgery

Fig 9: Diagnosis after Histopathology

Conclusions

The hysterectomy rate for  benign disease of women aged less than equal  to  40 at UHB is slightly higher than the national rate 12 % which is less than national rate 12.76%.The most common symptoms with which women presented is heavy menstrual bleeding and pain or both together.Its worth noting that most women were parous , and first line of management for HMB was done.All women have tried alternate treatment either conservative like medications , hormonal before hysterectomy was offered.Abnormal uterine bleeding and Endometriosis were the most common diagnosis.Histology report showed 96% women had hysterectomy for benign condition and it was unremarkable, 2% had cin ii, 1% had endometrial hyperplasia and 1% endometrial cancer (1a). 100 % compliance is seen in women according to NICE  guideline first line of management .

References

1. Surgical approach to hysterectomy for benign gynaecological disease

Johanna WM Aarts,Theodoor E Nieboer,Neil Johnson,Emma Tavender,Ray Garry

2.Hysterectomy for benign conditions

Patients and doctors will benefit from evidence based guidelines

Leroy C Edozien, consultant obstetrician and gynaecologist

3.Hysterectomy for Benign Conditions of the Uterus: Total Abdominal Hysterectomy Michael Moen 1

4.Surgical approach to hysterectomy for benign gynaecological diseases

Pickett CM, Seeratan DD, Mol BWJ, Nieboer TE, Johnson N, Bonestroo T, Aarts JWM.