Background: Hysterectomy for benign gynaecological conditions is effective in relieving
symptoms but ripple effects do occur. Hysterectomies are being performed for conditions where
alternatives are available so there is a trend of more surgeries. Not much is known about India, but
hysterectomy is very commonly performed.
Aim: Study was carried out to know trends of morbidity, mortality with hysterectomy for benign
gynaecological disorders in women of low resource settings.
Methods: Study commenced in 1998. Retrospective records were collected and prospective cases were included till
completion of 2 decades. Analysis of 4223case records of hysterectomies was done, at rural medical institute where most
patients are rural. Overall 3985 (94.4%) hysterectomies were performed for benign gynaecological disorders
(noncancerous tumours, inflammatory conditions, displacements, miscellaneous like adenomyosis, dysfunctional uterine
hemorrhage). Analyses was done by dividing into four five yearly blocks A,B,C,D to know the trends.
Results: Complications rate in abdominal hysterectomy was 19.39%, in Block A 26.42%, B 26.65%, C 18.72% and D
14.2%, 50% reduction in complications from recent past. Postoperative vaginal bleeding occurred in 1.18% in Block A,
0.37% in B, 0.52% in C and 0.7% in Block D. Wound infection rate decreased from 10.14% in Block A, 7.1% in D. Other
complications had decreasing trend. In vaginal hysterectomy complications rate was 11.14%, 15% in Block A, 18.61% in
B, 10.55% in C and 8.4% in D. Mortality was 0.1% (4 cases) 0.19% (one) in Block A, 0.14%(one) in B and 0.16% (2) in
C and no mortality in Block D.
Conclusion: Severe complications mortality can occur in hysterectomy for benign conditions also. Preoperative care,
intraoperative care can reduce morbidities, mortalities, but not totally eliminate, even in present times.