Introduction: Hysterectomy is the most common gynecological procedure. Abdominal approach is preferred for an enlarged uterus especially in cases of fibroids. However, in a small sized uterus, use of vaginal route is supported in well selected cases Objective: Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with the histopathology report for all hysterectomies, performed in a Shalamar Hospital Lahore. Methods: This study was crass sectional and population the obs. And Gyn. Patients of Shalamar Hospital Lahore. This study is a three year retrospective review of 755 cases of hysterectomy either for gynecological or obstetric reasons managed at Shalamar Hospital Lahore from January 2019 to December 2021. Results: Abdominal hysterectomy accounted for 94%, while vaginal hysterectomy accounted for the remaining 6%. In the former category, an 86% had total abdominal hysterectomy while 9% had subtotal hysterectomy. The average duration of hospital stay following surgery was 3-5 days. The average indoor stay was 2-3 days after vaginal hysterectomy and 4-5days after abdominal hysterectomy. There were 4 cases of mortality accounting for a mortality rate of 1.8 %. Post operative morbidity was encountered in 29.4% of the patients. Anaemia was observed in 45.9%,post operative wound infection in 30.1%, pyrexia in 9% patients, chest infection in 6.7%, bladder injury in 3.6%, bowel injury in 1.8% of the patients. Practical Implication: The practical implication of this study is to correctly treat the patients with pre-operative investigation, Complications, and Correlation of Preoperative Diagnosis with the Histopathology Report of Hysterectomies in private hospitals. Conclusions: Hysterectomy is a major gynaecological procedure. Selection of a appropriate route is very important for the safety of the patient and for hospital stay. Like any other surgery, hysterectomy has an inherent set of complications. So clinical selection should be well justified. Like in any major gynecological procedure, a skilled operator can reduce the morbidity and mortality rates. The conservative approaches should be offered before opting for hysterectomy. Keywords: Pre-operative investigation, Hysterectomies, complications, private hospital, Obs and Gyn patients
OBJECTIVE To report the frequency of causes of female infertility by laparoscopy in females presenting in a tertiary care hospital MATERIALS & METHODS Study design: Cross sectional study Setting: Department of Obstetrics & Gynecology, Shalimar Hospital, Lahore Duration of study: July 01, 2020, till July 31, 2021 DATA COLLECTION PROCEDURE: A total of 370 females fulfilling selection criteria were selected from operation theatre of Department of Obstetrics and Gynecology, Shalimar Hospital Lahore. Informed consent was obtained from each case. Demographic information (name, age, BMI, duration of marriage, type of infertility, and parity) will also be noted. Then females underwent laparoscopy under general anesthesia by researchers. On laparoscopy, the pelvis was inspected, including uterus, fallopian tubes, round ligaments, uterovesical pouch, uterosacral ligaments, and Pouch of Douglas. The tubes were inspected for any abnormality in their length and shape and patency was checked by retrograde dye test. Both ovaries were examined regarding their size, shape, thickness of peripheral follicles, evidence of ovulation and their relationship with fimbrial end of the tubes. Peritubal, periovarian and omental adhesions, tubo-ovarian masses, endometriotic deposits, fibroid, presence of fluid in the Pouch of Douglas or any other pathology, if present was noted. Data was entered and analyzed in SPSS version 21.0. RESULTS: The mean age of our cases was 33.93 ± 5.81 years with minimum and maximum ages of 18 and 45 years. According to the etiology of infertility, 5(1.4%) cases had unexplained infertility, 140(37.8%) cases had tubal infertility, 60(16.2%) cases had polycystic ovaries, 41(11.1%) cases had Peritubal and peri-ovarian adhesion, 71(19.2%) cases had endometriosis, 38(10.3%) females had fibroids and 20(5.4%) cases had an ovarian cyst. CONCLUSION: We conclude that on diagnostic laparoscopy the frequency of causes of female infertility was found to be tubal infertility (37.8%), followed by endometriosis (19.2%), polycystic ovaries (16.2%), Peri-tubal and peri-ovarian adhesion (11.1%), fibroids (10.3%), ovarian cyst (5.4%), unexplained infertility (1.4%).
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