Assessing the Histopathological Patterns of Lesions in Hystrectomy Specimen in Tertiary Care Hospital
Main Article Content
Abstract
Objective:
This research designed to investigate the frequency and histopathological spectrum
of hysterectomy specimens at DDRRL, DUHS, Karachi.
Methodology:
A descriptive cross-sectional study was performed over 10 months from Janu2023 to October 2023 at DDRRL, DUHS. A total of 259 hysterectomy specimens were included.
Patient demographic and clinical data were collected, and specimens were processed for
histopathological examination. Data analysis was achieved by using SPSS version 26, employing
descriptive statistics.
Results:
Mean age of patients was 40.02 years. The most common age group undergoing
hysterectomy was 31-40 years (35.5%). Total Abdominal Hysterectomy with Bilateral SalpingoOophorectomy (TAH+BSO) was the predominant procedure (75.3%). Most patients had high
parity (56.8% with five or more children). The primary clinical indications were abnormaluterine bleeding (AUB) (42.9%) and fibroids (29.7%). Histopathologically, endometrial lesions
were the most frequent (44.4%), followed by cervical (20.5%), myometrial (18.1%), and ovarian
lesions (17.0%).
Conclusion:
Hysterectomy is primarily indicated for AUB and fibroids in the studied
population. Histopathological examination predominantly reveals endometrial pathology. The
findings emphasize the importance of histopathological evaluation in hysterectomy specimens to
ensure accurate diagnosis and appropriate postoperative management.
Article Details
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
1. Neis KJ, Zubke W, Fehr M, Römer T, Tamussino K, Nothacker M. Hysterectomy for benign uterine disease. Dtsch Arztebl Int 2016;113(14):242-9. DOI: 10.3238/arztebl.2016.0242.
2. Marquini GV, de Oliveira LM, Martins SB, Takano CC, de Jarmy Di-Bella ZIK, Sartori MGF. Historical perspective of vaginal hysterectomy: the resilience of art and evidence-based medicine in the age of technology. Arch Gynecol Obstet 2023;307(5):1377-84. DOI: 10.1007/s00404-022-06607-z.
3. Nurfauzia YP. Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide: a systematic review. J Adv Res Med Health Sci 2023;9(8):2425. DOI: 10.53555/nnmhs.v9i8.1791.
4. Harvey SV, Pfeiffer RM, Landy R, Wentzensen N, Clarke MA. Trends and predictors of hysterectomy prevalence among women in the United States. Am J Obstet Gynecol 2022;227(4):611.e1-12. DOI: 10.1016/j.ajog.2022.06.028.
5. Lin CH, Long CY, Huang KH, Lo TS, Wu MP. Surgical trend and volume effect on the choice of hysterectomy for benign gynecologic conditions. Gynecol Minim Invasive Ther 2021;10(1):1-9. DOI: 10.4103/GMIT.GMIT_68_20.
6. Levy L, Tsaltas J. Recent advances in benign gynecological laparoscopic surgery. Fac Rev 2021;10:60. DOI: 10.12703/r/10-60.
7. Rattanakanokchai S, Kietpeerakool C, Srisomboon J, Jampathong N, Pattanittum P, Lumbiganon P. Perioperative complications of hysterectomy after a previous cesarean section: a systematic review and meta-analysis. Clin Epidemiol 2019;11:1089-98. DOI: 10.2147/CLEP.S235429.
8. Adnan M, Hussain W, Zaidi YA, Zeeshan F, Sultan BA, Parween S. Histopathological diversity in hysterectomy specimens at Jinnah Sindh Medical University laboratory. Pak J Health Sci 2025;6(7):53-9. DOI: 10.54393/pjhs.v6i7.3167.
9. Leal CRV, Vannuccini S, Jain V, Dolmans MM, Sardo ADS, Al-Hendy A, et al. Abnormal uterine bleeding: the well-known and the hidden face. J Endometr Uterine Disord 2024;6:100071. DOI: 10.1016/j.jeud.2024.100071.
10. Bibi S, Gul K, Mushtaq R, Bukhsh FM. Analysis of indications and different surgical approaches for gynecological hysterectomies at a tertiary care hospital. J Surg Pak 2022;27(3):95-9.
11. Noor S, Rana MS, Hanif A, John A, Noor A, Noor A, et al. Determinants of lack of family planning in grand multiparous women. Pak Biomed J 2021;4(1):73-82. DOI: 10.52229/pbmj.v4i1.75.
12. Ala SH, Husain S, Hussain S. Changing prevalence of emergency obstetric hysterectomy, its indications and maternal outcomes over a 4-year period at a tertiary care center in Pakistan. J South Asian Fed Obstet Gynaecol 2023;14(6):690-3. DOI: 10.5005/jp-journals-10006-2162.
13. Shrivastava K, Mishra RT, Tiwari P, Totade S, Dhakar JS. Histopathological spectrum of uterine lesions in hysterectomy specimens of patients with abnormal uterine bleeding. Int J Clin Trials 2024;11(4):252-9. DOI: 10.18203/2349-3259.ijct20242672.
14. Nerkar LS, Jagtap M, Lamkhade V. Histopathological study of adenomyosis and leiomyomas in hysterectomy specimens in patients of abnormal uterine bleeding at tertiary care centre. Int J Pharm Res Technol 2025;15(2):2432-40. DOI: 10.31838/ijprt/15.02.318.
15. Lonky NM, Chiu V, Portugal C, Estrada EL, Chang J, Fischer H, et al. Adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding associated with uterine leiomyomas. PLoS One 2023;18(12):e0294925. DOI: 10.1371/journal.pone.0294925.
16. Hadi S, Yasin S, Mati QA, Iqbal HA, Khattak LU, Khattak MT. Histopathological evaluation of hysterectomy specimens and their association with heavy menstrual/abnormal uterine bleeding. J Saidu Med Coll Swat 2024;14(2):74-8. DOI: 10.52206/jsmc.2024.14.2.805.
17. Krentel H, De Wilde RL. Prevalence of adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding, pelvic pain or uterine prolapse: a retrospective cohort study. Ann Med Surg (Lond) 2022;78:103809. DOI: 10.1016/j.amsu.2022.103809.
18. Kumar G, Pachori P. Addressing adenomyosis: implications beyond what we actually know. Int J Reprod Contracept Obstet Gynecol 2019;8(9):3644-8. DOI: 10.18203/2320-1770.ijrcog20193790.
19. Sudhakar LN, Milind J, Vikram L. Histopathological study of adenomyosis and leiomyomas in hysterectomy specimens in patients with abnormal uterine bleeding at tertiary care centre. Int J Pharm Res Technol 2025;15(2):2432-40.
20. Gopinath L, Vaidya R. Prevalence of adenomyosis and associated gynaecological pathologies in hysterectomy samples: a retrospective study. Int J Res Med Sci 2021;9(9):2606-9. DOI: 10.18203/2320-6012.ijrms20213203.
21. Wankhade R, Dawande P. Histopathological analysis of hysterectomy specimens in a tertiary care centre: a retrospective study. Cureus 2023;15(12):e50497. DOI: 10.7759/cureus.50497.
22. Ashwini K, Shreya SD, Sneha Reddy R, Sahana N. Clinicopathological analysis of hysterectomy specimens. Trop J Pathol Microbiol 2019;5(5):275-80. DOI: 10.17511/jopm.2019.i05.04.
23. Jandial R, Choudhary M, Singh K. Histopathological analysis of hysterectomy specimens in a tertiary care centre: study of 160 cases. Int Surg J 2019;6(8):2856-9. DOI: 10.18203/2349-2902.isj20193330.
24. Seles FM, Indira R. Incidental gynaecological malignancy in women who underwent hysterectomy for utero-vaginal prolapse: a 3-year institutional case study. Int J Reprod Contracept Obstet Gynecol 2018;7(9):3625-8. DOI: 10.18203/2320-1770.ijrcog20183765.
25. Elliott CG, Murji A, Matelski J, Adekola AB, Chrzanowski J, Shirreff L. Unexpected malignancy at the time of hysterectomy performed for a benign indication: a retrospective review. PLoS One 2022;17(4):e0266338. DOI: 10.1371/journal.pone.0266338.
26. Yildiz G, Mat E, Yildiz P, Gundogdu EC, Basol G, Kurt D, et al. The incidence of unexpected gynaecological malignancies in hysterectomies carried out for benign indications. J Obstet Gynaecol 2021;41(2):298-304. DOI: 10.1080/01443615.2020.1833849.
27. Topdagi Yilmaz EP, Cimilli Senocak GN, Topdagi YE, Aynaoglu Yildiz G, Kumtepe Y. Incidence of occult malignancies identified during hysterectomies performed for benign indications. J Gynecol Obstet Hum Reprod 2020;49(3):101620. DOI: 10.1016/j.jogoh.2019.08.003.
28. Ding Y, Han Y, Zhang S, Shi X. The incidence of unexpected uterine malignancies in hysterectomies carried out for benign indications. J Cancer Res Clin Oncol 2023;149(8):4339-45. DOI: 10.1007/s00432-022-04343-0.