Prevalence and determinants of hysterectomy in India

Abstract

Increase in the prevalence of hysterectomy among low-and middle-income countries (LMICs) such as India has become a significant concern. Reports based on either a particular group or region show an increasing trend in hysterectomy, but there is a dearth of national-level data in this domain. Hence, there seems to be an urgent need to garner evidence on the prevalence and determinants of hysterectomy, which could pave the way for future programs and policies. We aimed to estimate the prevalence of hysterectomy and assess its determinants using a nationally representative sample. An observational analysis was conducted using data from Longitudinal Aging Study in India (LASI), 2017–2018. 38,154 women aged > 18 years were included. A multivariable logistic regression, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI), was used to predict the association between various socio-demographic characteristics and hysterectomy. A separate multivariable logistic regression model was executed to determine the association between selected non-communicable diseases (NCDs) and hysterectomy. Survey weights compensated the complex study design. The overall prevalence of hysterectomy was around 11.35%. Excessive menstrual bleeding followed by fibroids emerged as the leading causes of hysterectomy. The various determinants of hysterectomy were urban residents [AOR: 1.54 (1.21–1.96)], other backward class [AOR: 2.19 (1.72–2.78], working women [AOR: 1.19(1–1.42)] and the most affluent (rich) group [AOR: 2.06 (1.62–2.63)]. Hysterectomy was associated with cancer [AOR: 4.83 (2.51–9.29)], diabetes [AOR: 1.79 (1.25–2.57)], hypertension [AOR: 1.48 (1.27–1.71)] and joint diseases [AOR: 1.43 (1.09–1.88)]. Hysterectomy is considerably prevalent in India, which cannot be overlooked. Health promotion regarding hysterectomy and its implications is needed especially among urban residents, affluent groups and those with a higher body mass index. Health programmes aimed at women should follow a life course approach by prioritizing health and overall well-being even after reproductive years.

Prevalence of hysterectomy and associated factors in Brazilian women aged 50 and older: findings from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil)

“…The main determinants were urban residency, working women and being from the most economically affluent group. Hysterectomy was associated with diabetes, hypertension, and joint diseases [ 5 ]. On the other hand, in Canada, hysterectomy rates were higher for the lowest neighbourhood educational quartile compared with the highest, higher with rural compared with urban dwelling, varied with local health service delivery area, and also varied non-linearly with neighbourhood income quintile [ 6 ].…”

Socio-Demographic and Related Indicators of Underwent Hysterectomy: A Cross-Sectional Study Conducted among the Women of District Bilaspur (CG), India

“…Change in attitude among the respondents included negative thoughts and feelings of missing organs or emptiness within the body (Turan et al, 2024). 7 Endometriosis, broids and heavy menstrual bleeding, severe pelvic pain, polycystic ovaries and uterus prolapse were some of the commonly reported indications for women who underwent hysterectomy (Rout et al, 2023;Kumari & Kundu, 2022). [8][9] According to a worldwide study among 22 countries by Nurfauzia, (2023) 10 placental pathology, placental accerta spectrum, uterine atony and uterine rupture are common problems leading to hysterectomy.…”

Therapeutic Management of Giant Uterine Fibroid: A Case Report

“…When symptomatic it presents with excessive or unusual menstruation, frequent and urgent urination, bowel dysfunction, lower back pain, increased pelvic pressure, urine retention, dyspareunia and constipation. The first imaging modality that is preferred is ultrasonography [ 3 ]. A lot of the information about the connection between symptoms and the presence of fibroids is based on clear studies that looked at how myomectomy affected presenting symptoms [ 4 ].…”