Hysterectomy: a 12-year retrospective review in the Yaounde University Teaching Hospital

The aim of the study was to describe the epidemiological profile of patients who had hysterectomy and determine the incidence, indications, types and complications of hysterectomy in the Gynaecology and Obstetrics Service of University Hospital Center in Yaounde (Cameroon). It is a retrospective review of all cases of hysterectomy over a 12-year period, from 1988 to 1999 inclusive. There were 183 cases of hysterectomy out of 1962 surgical operations giving an overall incidence of 9.33%. The mean age was 43.23 ± 8.53 years with a range of 15 to 65 years. Seven out of 111 (6.31%) women were nulliparous and 8 out of 111 (7.2%) had no living child. The major indications of hysterectomy were symptomatic leiomyomas (47.7%), cervical cancer (17.1%), uterine perforation (15.3%), severe cervical dysplasia (5.4%), uterine rupture (4.5%) and endometrial hyperplasia (2.7%). The three types of hysterectomy performed during this period were total hysterectomy (86.5%), Wertheim-Meigs radical hysterectomy (7.2%) and subtotal hysterectomy (6.3%). The commonest complications were per-operative haemorrhage (26.1%), urinary tract infection (36.9%), unexplained fever (18.9%), severe anaemia (13.5%) and wound infection (10.8%). Urinary tract infections were more frequent in patients whose indwelling catheters were maintained for more than 2 days. We therefore propose that after hysterectomy, the indwelling catheter should not be unduly extended beyond 2 days (except if there is a bladder injury) in order to reduce the rate of urinary tract infections. Clinics in Mother and Child Health Vol. 2(2) 2005: 347-350