Evolution in Indication´s Spectrum and Methods of Hysteroctomy in 3-years period

Overview

Objective:
The computer analysis of indications, operating approaches and techniques in 1085women undergoing hysterectomy was performed on our clinic. The evolution of indications, diagnosis and following operating approaches from 1997 to 1999 were analysed.Matherials and Methods: Retrospective computer data analysis of operating protocols using software PFANNENSTIEL 1.2. Results were obtained throw filtering archive file™s database.Results: Type of hysterectomy: abdominal 65%, vaginal hysterectomy 15%, radical hysterectomy12%, Laparoscopic assisted vaginal hysterektomy (LAVH) 8%.Type of diagnosis: uterine leiomyomas 46%, metrorrhagia 25%, urogynaecological diagnosis 25%,malignant tumors 19 %, pelvic inflammatory disseases (PID) 9%, pelvalgia 4%, combined diagnosis28%. Metrorrhagia - operating approaches - abdominal hysterectomy 80%, LAVH 17%. Myomatosis- operating approaches - abdominal hysterectomy 83%, LAVH 13%, vaginal hysterectomy 4%. Pelvalgia - operating approaches - abdominal hysterectomy 68%, LAVH 28%, vaginal hysterectomy3%. PID - operating approaches - abdominal hysterectomy 75%, LAVH 23%. Malignant tumors-operating approaches - radical hysterectomy sec. Wertheim or sec. Te-Linde 65%, abdominal hysterectomy 35%. Urogynaecological diagnosis - operating approaches - vaginal hysterectomy 59%,abdominal hysterectomy 37%.Conclusion: The reduction of abdominal approach towards hysterectomy by women with nononcological diagnosis since 1997 to 1999 (1997 - 85.8%, 1998 - 69.9%, 1999 - 53.7%) and increase ofvaginal hysterectomy (1997 - 10.4%, 1998 - 14.6%, 1999 - 17.5%) and LAVH was noted. Steep increaseof LAVH (1997 - 0.7%, 1998 - 5.4%, 1999 - 13.0%) shows the introduction of this method into routinespectrum of operating techniques. Indication spectrum of diagnosis leading to the hysterectomywithin three years did not change. Reduction of metrorrhagia (1997 - 26.9%, 1998 - 28.1%, 1999 -16.9%) and increase of malignant tumors (1997 - 11.2%, 1998 - 16.0%, 1999 - 22.1%) and PID (1997 -3.0%, 1998 - 10.3%, 1999 - 8.6%) was not significant.

Key words:
hysterectomy, indication, operating approaches, operating techniques