Seventeen-year review of hysterectomy procedures in a university clinic in Istanbul (1985-2001).

Objective: Our objective was to review the hysterectomies performed in our clinic for the last 17 years to reveal the facts in relation to the operation.
Materials and Methods: The records of the patients who had undergone hysterectomy in Istanbul University Cerrahpasa School of Medicine Department of Obstetrics and Gynecology between January 1985 and August 2001 were reviewed retrospectively. Students' t-test and one-way ANOVA test were utilized to compare the data of different hysterectomy groups.
Results: Between 1985 and 2001, there were 3,956 women who had undergone hysterectomy operation in the Department of Obstetrics and Gynecology of Cerrahpasa School of Medicine, Istanbul University. There were 3,274 (82.7%) total abdominal hysterectomies (TAH), 424 (10.7%) total vaginal hysterectomies (TVH), 28 (0.7%) subtotal hysterectomies and 230 (5.8%) radical hysterectomies. There were no significant differences in the distribution of hysterectomy type with respect to interval of years. The common indications for hysterectomy were myoma uteri (38.49%), followed by gynecological cancers (21.6%) and uterine prolapse (11.9%). The rate of concurrent procedures were 87.3% for TAH (2,856/3,274) and 95.8% for TVH (406/424). The rate of 'unjustified' hysterectomies (pathological diagnosis that is inappropriate to the indication of the operation) determined as 8.9% in all of the cases. The pathological examination of the specimen was normal in 170 cases (5.1%) of TAH. This rate was 42.1% (183/435) in TVH group. In the TAH group there was no complication in 86.5% of the cases while it was 89.3% in the TVH group. The most common complication was febrile morbidity in the whole group. During the study period, 5 deaths that can be attributed to the hysterectomy operation were observed. The mortality rate was calculated as 0.1% for hysterectomy operation in the study period.
Conclusion: Although it is widely performed, hysterectomy is a relatively safe surgical procedure. The morbidity and mortality of the operation may be further decreased by the efforts to minimize the rate of the unnecessary hysterectomies and selecting the most appropriate mode for the surgery.