Rafia Ansari, Sareeka Rathore, Bilqees Mustafa.
A review of clinical and pathological correlation for elective abdominal hysterectomy.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;18(2):75-8.

Objective: To study the correlation between clinical indication and the final histopatholigical diagnosis of hysterectomy specimen. Methods: Descriptive Cross sectional study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care hospital, Karachi, from 1st January 2011 to 31st December 2012. All patients undergoing hysterectomy for gynaecological diseases were studied. All obstetric and vaginal hysterectomies were excluded. Demographic characteristics, clinical features and indications for hysterectomy were recorded on a pre-designed performa. Surgical specimens were sent for histopathology. Reports were analyzed and compared with the indications of surgery. Results: A total of 313 major gynaecological operations were carried, out of which, (53.9%) were abdominal hysterectomies. Majority of the women were multiparous (Para 5 and above) and men age was 44.3 + 5.3 years. Frequent presenting symptom were abnormal uterine bleeding (59.8%), pain and abnormal uterine bleeding (21.9%), and mass in lower abdomen (8.3%). Most common indication for hysterectomy was dysfuntional uterine bleeding in 39.6%, followed by fibroid in 29.6% and adenomyosis in 8.9%. In the final histopathological reports of the hysterectomy specimens, pre-operative diagnosis waas confirmed 100% in cases of malignancy, endometrial hyperplasia, adnexal masses, endometriosis and pelvic inflammatory disease. Disparity was found between clinical and histopathological diagnosis in cases of fibroid (26.6% clinical and 32.6% histopathological), dys-functional uterine bleeding (39.6% clinical nd 16.6 histopathological) and adenomyosis (8.9% clinical and 23.7% histopathological). Conclusion: Histopathological analysis correlates well with the pre-operative diagnosis for hysterectomy in cases of fibroid, malignancy, endometriosis, endometrial hyperplasia and pelvic inflammatory disease. Histopathology must be mandatory for ensuring diagnosis and thus management, in particular of malignant disease.

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