Hysterectomy in the Niger Delta of Nigeria: A Clinical Study of Indications and Outcome

Abstract

Most of the women in our environment abhor hysterectomy but it remains the only option in most cases in our practice of gynaecology due to late presentation when it becomes more difficult to offer a less radical management options. This study aims to evaluate the indications, clinical characteristics and management outcome in the Niger Delta of Nigeria. This is a retrospective analysis of all Hysterectomies performed from 1st January, 2000 through 31st December, 2005 at the University of Port Harcourt Teaching Hospital. There were 170 cases of elective hysterectomy out of a total of 1025 elective major gynaecological surgeries during the study period with hysterectomy prevalence of 16.6%. The mean age of the patients was 46.5 years, 21(13.55%) of the women were nulliparous. The major indications were symptomatic uterine fibroid 55.5%, ovarian tumour 14.8% and uterovaginal prolapsed 8.4%. The surgery in 92 (59.4%) patients was performed by consultants. The crude morbidity and case fatality rates was 45.45% and 3.87% respectively. Elective hysterectomy for gynaecological condition remains a valid management option in our environment. The use of peri-operative antibiotics is advised to reduce the incidence of post-operative morbidity.

Indications and Outcomes of Abdominal and Vaginal Hysterectomies at Tertiary Hospital in Nnewi, Nigeria

“…From the study, the hysterectomy was performed commonly on women who aged 40-49 years. This is comparable to what was found in other studies in Nigeria [3,12,16].…”

“…More complications are found in women who had abdominal hysterectomy than in those who had vaginal hysterectomy. This is comparable to findings from other studies [5,12]. This could be due to extensive tissue dissection with its associated morbidity in abdominal hysterectomy when compared with vaginal hysterectomy.…”

Hysterectomy For Gynaecological Conditions At Nguru, North Eastern Nigeria: A Retrospective Study

“…Eight (12.1%) of our patients were nulliparous, however of advanced age and most of them have had previous myomectomy. This is higher than 8.7% reported by Bukar et al but lower than 16.9% reported by Obilahi et al 7,16 Most of those who had abdominal hysterectomy on account of uterine fibroids were of low parity while vaginal hysterectomy for utero-vaginal prolapse were observed more in women with higher parities as seen in all those having more than 10 deliveries. The abdominal approach is the preferred route of hysterectomy in this center with 84.8% abdominal hysterectomy to 15.2% vaginal hysterectomy given a ratio of 5.6: 1 abdominal to vaginal hysterectomies; the same trend was reported from the UK.…”

5-year review of hysterectomy at the Delta State University Teaching Hospital, Oghara, south-south Nigeria

“…Differences exist in the rate of hysterectomy from country to country and in different settings in Nigeria. In Nigeria, it accounted for 8.5% to 18.2% of all major gynaecological operations in both secondary and tertiary health care facilities across 1,[6][7][8][9][10][11][12][13][14] Nigeria. Approximately 20% of women at age 55 would have undergone hysterectomy in the United Kingdom, mainly for menstrual disorders and 4 uterine fibroids.…”

“…Also in Demark an estimated one in every ten women would have 1 hysterectomy in their life time. Studies done in the Niger Delta region of Nigeria, where DELSUTH is located, have reported abdominal hysterectomy to account for 81.9% to 9,10,12,13 91.6% of all hysterectomies being done.…”