A retrospective clinico-pathological study of hysterectomy cases in a tertiary care hospital in India – a review of 950 cases.

Introduction: Hysterectomy is the most commonly performed gynaecological surgery in India as well as in abroad. It is frequently done in myometrial and endometrial pathologies and rarely for other causes. Hysterectomy is definitive management for diseases like fibroid, adenomyosis, dysfunctional bleeding, prolapsed uterus and malignant lesions of uterus and adenexa. We aimed our study to observe incidence of different pathologies of uterus and other reproductive organs in hysterectomy specimens and retrospective correlation between clinical diagnosis and histopathological finding of hysterectomy cases.Materials and Methods: Retrospective data were collected from our routine histopathological laboratory. Detailed history, clinical examination and operative findings and provisional diagnosis of all 950 hysterectomy cases were recorded during study period of 2 years. Histopathological diagnosis was correlated with clinical and preoperative diagnosis.Observations: Abdominal hysterectomy (734 cases, 77.26%) was the most common route of approach during surgery. Common pre-operative diagnoses were fibroid uterus (32%), dysfunctional uterine bleeding (28.95%), uterine prolapsed (22.74%). Other causes included uterine polyps (1.6%), complications of pregnancy (2.74%), ovarian tumours (8.42%), cervical carcinomas (2.97%) etc. Common pathologies on histology were leiomyoma (32%), adenomyosis (20.32%), atrophic endometrium (17.26%) and endometrial pathology (8.95%).Discussion: Our study has been correlated with other studies of India and other south Asian countries. Most common indication of hysterectomy in our study is dysfunctional uterine bleeding (32%) but Gupta et al and Jha R et al found utero-vaginal prolapse as most common indication. Leiomyoma was the most common histology diagnosed in the present series. Clinical diagnosis was possible in 67.57% cases in our study similar to Khan et al (70.51%).Conclusions: Histopathological examination of hysterectomy specimens helps to detect the exact causes and underlined pathology.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.88-92

Download Full-text

HISTOPATHOLOGICAL STUDY OF UTERINE LESIONS IN HYSTERECTOMY SPECIMENS IN A TERTIARY CARE HOSPITAL.

10.36106/ijsr/8128882 ◽

2020 ◽

pp. 1-2

Author(s):

Reddythota Sujeeva Swapna ◽

V Siva Sankar Naik ◽

C Bhavani ◽

M Neeraja

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Female Genital Tract ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

The Body ◽

Histopathological Study ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Wide Range

Background: The Female Genital Tract is a hormone-responsive system to a degree unmatched by any other system in the body. The gross configuration of the uterus changes dramatically throughout life. It is a kind of 'Puppet on a string", thus manipulated throughout life by altering levels of ovarian hormones. Objective of the study: The present study is aimed at detailed histopathological evaluation of uterine lesions of hysterectomy specimens. Methodology: A total of 448 cases of hysterectomy specimens were received in the department of pathology GGH Ananthapur, for two years, were reviewed. The specimens were processed, and the histopathological diagnosis was studied. Result: Peak age group of hysterectomy was 40-49 years with 186 (41.51%) cases. The youngest patient was 21 years old, and the oldest was 75 years old. The most frequent type of hysterectomy done was total abdominal hysterectomy in 293 (65.4%) cases. Conclusion: Hysterectomy is the most common surgery performed in gynecological practice. A wide range of lesions were noted when hysterectomy specimens are subjected to histopathological examination.

Download Full-text

A STUDY OF 70 CASES OF DUB

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i11.718 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Dr. Yogesh C. Parmar

Keyword(s):

Low Socioeconomic Status ◽

Social Life ◽

Treatment Options ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Care Hospital ◽

Dysfunctional Uterine Bleeding ◽

Medical Disorders ◽

Number Of Patients

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of dysfunctional uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders. Methods: A retrospective study of randomly selected 70 cases of dysfunctional uterine bleeding admitted during October 2006 to September 2007, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. Only cases of AUB due to non-structural causes were included. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months. Results: Most common age group presenting with DUB was 40–50 years and mostly belonged to low socioeconomic status. Most of the women were multiparous. Polymenorrhagia and menorrhagia was most common presentation. Size of uterus is normal in 44 patients. Dilatation and curratage was having the cure rate of 65.6% .Maximum number of patients (85%) was treated surgically and 15% got medical treatment. Conclusions: Dysfuntional uterine bleeding (DUB) now termed as Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment. Keywords Menorrhagia, Dysfunctional uterine bleeding,Abnormal uterine bleeding Perimenopausal women, Endometrium

Download Full-text

Clinicopathological correlation of abdominal hysterectomy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204781 ◽

2020 ◽

Vol 9 (11) ◽

pp. 4361

Author(s):

Tara Manandhar ◽

Sarita Sitaula ◽

Baburam Thapa Dixit ◽

Ajay Agrawal

Keyword(s):

Abnormal Uterine Bleeding ◽

Laparoscopic Hysterectomy ◽

Abdominal Hysterectomy ◽

Uterine Bleeding ◽

Common Finding ◽

Clinical Indication ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Common Indication ◽

Fibroid Uterus

Background: Hysterectomy is the most common gynaecological procedure performed worldwide. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. Fibroid uterus is the most common indication for hysterectomy followed by pelvic organ prolapse, benign ovarian tumour and abnormal uterine bleeding. The objective of this study was to analyse the indication, outcome and correlate the clinical indication with the histopathological diagnosis.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, from January 2017 to December 2019. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.Results: A total of 801 patients underwent abdominal hysterectomy and the most common indication was fibroid uterus (n=391, 48.81%), followed by abnormal uterine bleeding. The total complication rate was 3.24% (n=26) and we had one (0.1%) mortality. Histopathological analysis of the specimen revealed leiomyoma (54.43%) as the most common finding. The clinical indication and histopathological diagnosis matched in 373 (86.94%) patients.Conclusions: Abdominal hysterectomy is the most common approach and it is associated with risk of complications, so the indication for hysterectomy should be adequately evaluated. With the improvement in the different organ-preserving options, hysterectomy in benign disease should only be opted when all the other conservative options fails.

Download Full-text

A retrospective study on indications and histopathological analysis of non-oncological hysterectomies in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204962 ◽

2020 ◽

Vol 9 (12) ◽

pp. 5050

Author(s):

Ananthi Kasinathan ◽

Himabindu Nagulapally

Keyword(s):

Retrospective Study ◽

Clinical Diagnosis ◽

Ovarian Cyst ◽

Preoperative Evaluation ◽

Tertiary Care ◽

Pelvic Organ ◽

Clinical Indication ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Care Hospital

Background: An increase in the number of women undergoing hysterectomy especially in South India is of great concern. Whenever hysterectomy is performed, it is imperative that clinical diagnosis is accurate. The purpose of current study is to assess whether the histopathological diagnosis after surgery is correlated with the clinical diagnosis. Methods: This is a retrospective study conducted in the department of obstetrics and gynaecology at Indira Gandhi medical college and research institute Puducherry, from January 2018 to December 2018. Patients, who underwent hysterectomy for benign causes, were included in the study. Data was collected from the patients' case records. Whether the histopathological diagnosis was in tandem with the clinical diagnosis, was notedResults: Out of the 234 hysterectomies performed, 46.15% were by abdominal route and 53.84% were by vaginal route. 24.7% were TAH with BSO with mean age of 49.72 years. VH with PFR (46.5%) was the most common surgery done. Out of the 80 cases of fibroid, 66 (28.2%) were confirmed on histopathology. Histopathological diagnosis corroborated the clinical diagnosis in patients with ovarian cyst, fibroid with ovarian cyst and DUB. Adenomyosis was validated in 7 of 9 cases. Endometriosis of ovary was confirmed in 4 (1.7%) cases. In patients with pelvic organ prolapse, histopathology showed atrophic changes.Conclusions: Accurate clinical diagnosis, supported by in-depth preoperative evaluation and a sound clinical knowledge helps to avoid unnecessary hysterectomies. It is imperative to study the histopathology of the operated specimen and confirm the appropriateness of the clinical indication.

Download Full-text

Patterns of Lesions in Hysterectomy Specimens in a Tertiary Care Hospital

Journal of Nepal Medical Association ◽

10.31729/jnma.2698 ◽

2015 ◽

Vol 53 (197) ◽

pp. 18-23 ◽

Cited By ~ 1

Author(s):

Sujan Vaidya ◽

Sapana Amatya Vaidya

Keyword(s):

Clinical Diagnosis ◽

Tertiary Care Hospital ◽

Histopathological Examination ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Operative Management ◽

Uterovaginal Prolapse ◽

Care Hospital ◽

Ovarian Tumours ◽

Operative Indications

Introduction: Hysterectomy is one of the most common gynaecological procedures performed all over the world. The most frequent indications for hysterectomy are fibroids, abnormal uterine bleeding uterovaginal prolapse and endometriosis. The objective of this study was to present the histopathological patterns of various uterine and adnexal pathologies in the hysterectomy specimens and also to correlate its pre-operative clinical diagnosis with histopathology. Methods: This is a two-year descriptive study of hysterectomy specimens carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all the hysterectomy specimens collected during this period was analyzed. Results: Out of the 533 cases, fibroid was the most common indication for hysterectomy that was seen in 229 (42.94%) cases followed by uterovaginal prolapse in 101 (18.93%) cases. Leiomyoma was the most common pathology reported in 250 (46.90%) hysterectomy specimens, followed by ovarian tumours in 95 (17.82%) cases. In 17.82% (95/533) cases, no pathology was seen. Overall, the pre-operative indications in 533 cases of hysterectomy were histopathologically verifiable in 487 (91.37%) cases. Conclusions: Though the histopathological examination correlates well with the pre-operative clinical diagnosis, a number of lesions were also encountered as pure incidental findings. Hence, it is mandatory that every hysterectomy specimen should be subjected to histopathological examination so as to ensure better post-operative management. Keywords: adenomyosis; hysterectomy; leiomyoma; tumour; uterovaginal prolapse.

Download Full-text

HISTOPATHOLOGICAL STUDY OF BENIGN AND MALIGNANT LESIONS OF UTERUS AND CERVIX IN HYSTERECTOMY SPECIMENS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i1.1666 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Shikha Raghuwanshi ◽

Dharmendra Singh Bhadouria ◽

Surendra Raghuwanshi ◽

Arun Saxena ◽

S.K. Nema

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Common Finding ◽

Histopathological Study ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Fibroid Uterus ◽

Malignant Lesions ◽

Chronic Cervicitis ◽

Insight Into

Background: The present study was aimed to obtain insight into the varied histopathological patterns of lesions of uterus and cervix in hysterectomy specimens and their age-wise distribution in Index MedicalCollege, Hospital and Research Center. Methodology: This was anobservational study conducted on 100 cases of hysterectomy specimens received at tertiary care hospital Indore. All the specimen was subjected to detailed gross and histopathological examination. Results: Mean age of patients was 44.78±8.64 years. The most common age group was 41-50yrs (42%). Maximum cases were diagnosed as AUB/ DUB/Menorrhagia (31%) followed by fibroid uterus (28%). Uterus was bulky in 70%, cut sections revealed single fibroid in majority i.e. 39% cases and endometrium was in proliferative phase (early 12%, mid 30%, late 19%). Most common histopathological diagnosis of uterus was leiomyoma in 39% cases whereas chronic nonspecific cervicitis (47%) was most common histological diagnosis of cervix. Intramural leiomyoma were most common and were associated with degenerative changes in 33 cases. Hyaline degeneration was observed in maximum cases. Conclusion: The most common indication for hysterectomies in our institution is excessive uterine bleeding. Fibroid uterus as the cause of bleeding is the most common pathology for which hysterectomy is performed. Chronic cervicitis is the most common finding and Adenomyosis continued to be missed preoperatively and diagnosed postoperatively on histopathological examination. Every hysterectomy specimen should be subjected to histopathological examination to confirm various pathological lesions. Keywords: Leiomyoma, histopathology, spectrum, uterus, cervix, hysterectomy

Download Full-text

Clinicopathological profile of sinonasal masses-a tertiary care centre study in rural India

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204182 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1821

Author(s):

Vidya Rokade ◽

Kiran J. Shinde ◽

Girishkumar R. More

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Rural India ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Tertiary Care Centre ◽

Radiological Investigation ◽

Male Predominance ◽

Neoplastic Lesion ◽

Neoplastic Lesions

Background: A variety of mass lesions occur within the paranasal sinus (PNS) and nasal cavity and thus it becomes mandatory for otorhinolaryngologist to elicit detailed history and thorough examination before reaching a final diagnosis. This is retrospective study of all sinonasal masses who were undergone surgical management in the institute of rural India and so in the environment.Methods: This is a retrospective observational study of 70 patients with sinonasal masses treated at a rural tertiary care hospital in rural western Maharashtra from period of Jan 2016 to May 2018. History, clinical assessment and histopathological examination (HPE) was done in all cases as per hospital record supplemented by radiological investigation as per requirement. The patients were grouped as per their histopathological diagnosis as non-neoplastic/inflammatory and neoplastic.Results: A total of 70 patients were analysed age ranging (11-70 years). Majority of the patients were in the age groups 21-40 years (47%). There were 43 (61%) male and 27 (39%) female with M:F ratio 1.6:1. On HPE, 50 (71%) cases were non neoplastic/inflammatory and 20 (29%) cases were neoplastic lesions. HPE revealed that 50 (71%) cases were non neoplastic and 20 (29%) cases were neoplastic lesions.Conclusions: Sinonasal masses have various differential diagnoses. They are fairly common with male predominance. Benign conditions show a peak during 2nd to 4th decade of life while malignancy increasing with the age after 4th decade. In non-neoplastic lesion, Allergic nasal polyp is the commonest histological pattern seen while in malignant lesions squamous cell carcinoma is noted with 100% male predominance.

Download Full-text

Histopathology diagnosis in women who underwent a hysterectomy for a benign condition.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.04.3427 ◽

2020 ◽

Vol 27 (04) ◽

pp. 721-724

Author(s):

Night Afridi ◽

Amna Fareed ◽

Saira Nazeer ◽

Saifullah Khan ◽

Shah Gul Khan

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Study Data ◽

Histopathological Finding ◽

Ethical Review ◽

P Value ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Benign Condition ◽

Gynecology And Obstetrics

Objectives: To determine frequency of histopathological diagnosis in women who underwent hysterectomy for benign condition in tertiary care hospital. Study Design: Retrospective study. Setting: Department of Gynecology and Obstetrics, CMH Nowshera. Period: 6 months (July 2018 December 2019). Material & Methods: Data of all hysterectomies underwent in last 3 years was reviewed. Ethical approval was taken from ethical review board. Patients undergone hysterectomy with benign condition were included in study. Data was analyzed using SPSS version 24. Chi-square and correlation test was performed. P value ≤0.05 was considered significant. Results: Total 430 cases were included in study. Mean age of women was 37.1 years± 8.2 SD. Most common complaints was irregular bleeding 123(28.6%) following dysmenorrhea 78(18.1%). Most common histopathological finding was adenomyosis 214(49.8%), following leiomyoma 66(15.3%). Histopathological findings were significantly associated parity (p=0.000), type of hysterectomy (p=0.000), marital status (p=0.000) and occupation (p=0.000). Significant correlation between clinical diagnosis and histopathological finding was found (r= 0.7, p=0.00). Conclusion: Hysterectomy is most common surgical modality in gynecology. Adenomyosis is most common histopathological finding in patients undergone hysterectomy for benign condition. All hysterectomy specimens should be subjected to pre-operative and post-operative histopathological examination for accurate diagnosis and management in benign conditions.

Download Full-text

A STUDY OF CLINICAL CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING AT JLNMCH, BHAGALPUR, BIHAR

10.36106/ijsr/2632845 ◽

2021 ◽

pp. 73-74

Author(s):

Archana Jha ◽

Satyendra Kumar ◽

[Prof.] Usha Kumari ◽

Debarshi Jana

Keyword(s):

Clinical Diagnosis ◽

Histopathological Examination ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Clinical Impression ◽

Histopathological Diagnosis ◽

Endometrial Sampling ◽

Carcinoma Of Cervix ◽

Perimenopausal Women ◽

Pathological Evaluation

Background: Abnormal uterine bleeding in perimenopausal women accounts for about 70% of gynaecologic Outpatient Department visits. Perimenoppause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more or less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Polymenorrhagia, intermenstrrual bleeding and metrorrhagia are other common disorders at perimenopause. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding after ruling out medical causes. The present study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with clinical diagnosis and histopathological examinations. A total of 150 perimenopausal Material and Methods: women with abnormal uterine bleeding in the age group of 37-51 years for a period of 6 months were included. These women were evaluated clinically and ultrasonographically for the cause of abnormal uterine bleeding. Clinical impression and USG reports were correlated. These women underwent dilatation and curettage for endometrial sampling and specimen sent for histopathological examination. Histopathological reports were correlated with clinical diagnosis. Most of the patients with AUB were Results: between 37-41 years of age (56%). The incidence was high in parity-3 (26%) annd grand multipara (49.33%). The majority of the women were presented with menorrhagia (54.66%). Clinically, majority of the cases were diagnosed as broids 66 (44%) followed by dysfunctional uterine bleeding (DUB) 56 (37.33%). However, histopathological reports conrmed broid in 52 cases, DUB in 49, adenomyosis in 36 and polyp in 11 cases. Fibroi Discussion: ds are common nding in women with menorrhagia. Clinical, radiological and pathological evaluation correlated very well to diagnose broids and DUB. However clinically as well USG proved of little help to diagnose adenomyosis and carcinoma of cervix and endometrium. Thus, histopathological evaluation of endometrium is recommended in perimenopausal women.

Download Full-text

HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM IN WOMEN WITH ABNORMAL UTERINE BLEEDING

10.36106/ijsr/6103945 ◽

2021 ◽

pp. 30-33

Author(s):

Bhakti D Deshmukh ◽

Anuradha Malpani ◽

Alka V Gosavi ◽

Kalpana R Sulhyan ◽

Rucha M Pimpalkhute

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Intraepithelial Neoplasia ◽

Mucinous Carcinoma ◽

Uterine Bleeding ◽

Serous Carcinoma ◽

Histopathological Study ◽

Care Hospital ◽

Age Group

BACKGROUND –Abnormal uterine bleeding (AUB) is dened as a bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle. The term dysfunctional uterine bleeding (DUB) is used to describe abnormal uterine bleeding for which no specic cause has been found. AUB is one of the most common gynaecological problems. This study was done to evaluate histological patterns of endometrium in women with abnormal uterine bleeding. AIMS AND OBJECTIVE – To study various histological patterns of endometrium in abnormal uterine bleeding and correlate it with age, parity and symptoms. MATERIAL AND METHODS –This is a retrospective study, conducted in the Department of Pathology, in a tertiary care hospital from 1st July 2016 to 30th June 2019. Total 718 specimens with AUB were included in the study from the age group of 21 to 95 years. The specimens received were hysterectomy (74.65 %), endometrial biopsies (21.45%), dilatation and curettage (2.79 %) and transcervical resection of endometrium (1.11 %). RESULTS –The patients with AUB were mainly from the age group 41-50 years with menorrhagia as the chief complaint. Most of the women with AUB were multiparous (84.54%). The most common pattern observed on histopathological examination was proliferative endometrium (49.86%) followed by atrophic endometrium (10.31%). Malignancy was found in 2.23% (Endometrioid carcinoma – 1.81%, serous carcinoma - 0.14% and mucinous carcinoma – 0.28%). Endometrial hyperplasia without atypia (23 cases, 3.20%) was more common than endometrial atypical hyperplasia (EAH) / endometrioid intraepithelial neoplasia {EIN} (4 cases, 0.56 %). Various other patterns of endometrium on histopathology were endometritis (6.82 %) followed by endometrial polyp (4.46 %). CONCLUSION – Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.

Download Full-text