Abstract
Objective
To determine the influence of age and parity on consent for non-emergency hysterectomy in each of the indications, type of hysterectomy performed, and the difference in their outcomes.
Patients and methods
A 6-year prospective study of all cases of non-emergency hysterectomy at Aminu Kano Teaching Hospital, Kano, Nigeria. The data obtained were analysed using Epi-Info 3.2.2, 2004 statistical software. Chi-square test and exact probability test were used to determine significant associations. A P value of <0.05 was considered significant.
Results
Non-emergency hysterectomy accounted for 16.7% of all major gynaecological operations. The mean age of the women was 42.22 ± 8.36 years, and mean parity was 5.84 ± 3.24. Age and parity did not significantly influence respondents against giving consent for non-emergency hysterectomy in all the indications, except for age and uterine fibroids. The commonest indication was uterine fibroids (58.2%). There was a preference for abdominal hysterectomy. Post-operative complications were less with vaginal hysterectomy. The morbidity rate was 26.9% and there was no mortality.
Conclusion
Non-emergency hysterectomy is a fairly safe procedure in Aminu Kano Teaching Hospital, Kano. Early marriage and childbearing significantly reduced the aversion to non-emergency hysterectomy. Increase in the use of vaginal hysterectomy where it is not contra-indicated should be encouraged in order to reduce the morbidity. Laparoscopic assisted vaginal hysterectomy will go a long way to achieve this goal when available in our unit. Efforts should be made to train gynaecologists in minimal access gynaecological surgeries.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gyam A (2000) Elective hysterectomy at Tikur Anbessa Teaching Hospital, Addis Ababa. Ethiop Med J 40(3):217–226
Dare F, Ademowore A (1989) Elective hysterectomies in Ife University Teaching Hospitals Complex—a 5 year review. Niger Med J 19:130–136
Sandberg S, Narnes B, Weinstein M, Braun P (1985) Elective hysterectomy—benefits, risks and cost. Medicare 23(9):1067–1085
Tracee C (2007) Hysterectomy alternatives. Women’s Health. April 2007
Ezen V, Otubu J (1981) Hysterectomy in the Hausa/Fulani population. Int J Gynaecol Obstet 19:145–147. doi:10.1016/0020-7292(81)90054-0
Bachmann GA (1998) Hysterectomy, a critical review. Am J Med 3:839–862
Cava E (1975) Hysterectomy in a community Hospital. Am J Obstet Gynecol 122:434–438
Ogunbode O (1981) Environmental factors in the management of uterine fibroids. Trop J Obstet Gynaecol 2:119. doi:10.3109/01443618109067435
Olatinwo A, Offiong R (2000) An analysis of surgically treated cases of uterine fibroids at the University of Ilorin Teaching Hospital Ilorin Nigeria. Nig J Surg Res 2(1):6–11
Ezenwafor G, Jimoh G (2007) Abdominal hysterectomy at the University of Ilorin Teaching Hospital, Ilorin—a 5-year review. Nig Hosp Pract 1(2):45–49
Teplin V, Vittighoff E, Fen Lin MS, Learman AL, Richter HE, Kuppermann M (2007) Oophorectomy in premenopausal women. Obstet Gynecol 109:347–354
Omole Ohonsi A, Ashimi AO (2008) Pre-eclampsia—a study of risk factors. Niger Med Pract 53(6):99–102
Udoma E, Ekanem E, Udo A, Eshiet A (2003) Hysterectomy among nulliparous women in Calabar. Indications, complications, social implications, and management outcome. Glob J Med Sci 2(2):135–139
Onah H, Ezegwui H (2002) Elective abdominal hysterectomy: indications and complications in Enugu, Eastern Nigeria. Glob J Med Sci 1:49–53
Ola ER (2006) Tumours of the ovary. In: Agboola A (ed) Textbook of obstetrics and gynaecology for medical students, 2nd edn. Heinemann Educational Books, Lagos, pp 197–217
Louve DG (1999) Benign diseases of the uterus. In: Edwards, Keith (eds) Dewhurst’s textbook of obstetrics and gynaecology for postgraduates, 6th edn. Blackwell, Oxford, pp 552–559
Roberts O, Okunlola M (2001) Abdominal hysterectomy for benign gynaecology conditions at Ibadan, Nigeria. Trop J Obstet Gynaecol 18(1):19–23
Omole-Ohonsi A, Mohammed Z (2005) Caesarean section in Kano, Northern Nigeria. J Niger Clin Rev 9(6):8–13
Shaw W (1997) Postoperative treatment and complications. In: Howkins J, Hudson C (eds) Shaw’s textbook of operative gyanecology, 4th edn. Churchill Livingstone, London, pp 71–111
Panda S, Panda V (2000) Antibiotic prophylaxis in elective hysterectomy. Paper presented at the fourth all India congress of obstetricians and gynaecologist, Ahmadabad. December 2000
Parker R, Thagana N, Otieno D (2004) Laparoscopic assisted vaginal hysterectomy for benign uterine pathology: is it time to change? East Afr Med J 81(5):261–266
Onah H, Ezegwui H (2002) Increasing the use of vaginal route for hysterectomy in Nigerians: A critical appraisal. J Coll Med 7(1):13–15
National Population Commission (1999) Fertility, National Demographic and Health survey of Nigeria, pp 35–43
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Omole-Ohonsi, A., Ashimi, O.A. Non-emergency hysterectomy: why the aversion?. Arch Gynecol Obstet 280, 953–959 (2009). https://doi.org/10.1007/s00404-009-1040-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-009-1040-1