Clinical Indications for Total Abdominal Hysterectomy among Women Seen in Dar es Salaam Regional Referral Hospitals, Tanzania: A Prospective, Observational Hospital-Based Study

6^th Annual Congress on Gynecology and Women's Health

November 21, 2022 | Webinar

Godfrey J Chale, Rashid M. Salim, Kelvin M Leshabari

Ultimate Family Healthcare Trust, Tanzania
Kampala International University, Tanzania

Posters & Accepted Abstracts: J Nurs Res Pract

Abstract :

Statement of the Problem: Total abdominal hysterectomy is among the commonest gynaecologic surgeries observed in Africa. However, there exists a gap in published data to support this hypothesis. Information on hysterectomies reported from sub- Saharan Africa reflects mostly obstetric indications. The purpose of this study was to assess and document clinical indications for total abdominal hysterectomy in Dar es Salaam hospitals. Methodology & Theoretical Orientation: A prospective hospital-based study was conducted in Dar es Salaam, Tanzania from March-October 2017. Women attending the facilities with clinical conditions necessitating abdominal hysterectomies were the target population. Each woman was followed from the time of planning for surgery until at most 72-hours post-surgery or discharge from the wards whichever came first. Continuous variables were summarized using median (with corresponding interquartile range). Categorical variables were summarized using frequency (%). Data outputs were created using SAS version 9.4. Verbal informal consent was sought from each individual prior to inclusion to this study. Findings: We recruited and prospectively followed-up 107 patients. Median age of participants was 42 (IQR: 37-47) years. Uterine leiomyoma (84.1%) was the leading indication for hysterectomy. Only about a third (30.8%) of followed-up women had provisional diagnoses at the time of surgery. None of the study participants reported receipt for confirmatory histological findings of her uterus up to the hospital discharge time post-surgery. Conclusion & Significance: Uterine leiomyoma was the leading indications for total abdominal hysterectomy in Dar es Salaam, Tanzania. No histological findings to back up diagnoses were given back to patients at the time of the study. Recommendations: Regular clinical audits on surgical interventions are warranted in this setting. References 1. Aboulfoutou M, Chaalan F. and Mohammed A. Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiary hospital. Gynecol. Surg. 2020; 17:1. 2. ©American College of Obstetricians and Gynecologists (2017) Choosing the route of hysterectomy for benign disease. ACOG Committee Opinion No. 701. Obstet Gynecol 129:e155–e159 3. Wright JD, Chen L, Burke WM et al (2016) Trends in use and outcomes of women undergoing hysterectomy with electric power morcellation. JAMA 316:877 4. Multinu F, Casarin J, Tortorella L, Huang Y, Weaver A, Angioni S, Melis GB, Mariani A, Stewart EA, Laughlin-Tommaso SK (2019) Incidence of sarcoma in patients undergoing hysterectomy for benign indications: a population-based study. Am J Obstet Gynecol 220(2):179.e1–179.e10