title: Justification rate for non-obstetric hysterectomies: a study of cases in University of Calabar Teaching Hospital, Calabar.
abstract: BACKGROUND
  Hysterectomy is a commonly performed major, non obstetric operation. It is often the definitive treatment for several pelvic pathologies like uterine myoma, utero-vaginal prolapsed, dysfunctional uterine bleeding, cervical malignancy and uncontrollable post partum haemorhage. The use of the hysterectomy in women sometimes without disease has led to the perception that some of the indications for hysterectomy are unjustified. The aim of this study is to determine the justification rate for the procedure in the University of Calabar Teaching Hospital, Calabar.
  
  
  METHODS
  This was a retrospective study of hysterectomies done at the University of Calabar Teaching Hospital between January 2001 and December 2005. The preoperative indication was compared with the pathologist's report after surgery. Hysterectomy was considered justified if the pathology report verified the indication for surgery or showed a significant alternative pathology.
  
  
  RESULTS
  The indication for hysterectomy corresponded with the histopathological diagnosis in 76.7% of cases, while in 23.3% cases the indication and histopathological diagnosis did not correspond, out of these 3.3% of cases had significant alternative pathology. In this study 80% of all hysterectomies were justified while it was not justified in 20% of cases.
  
  
  CONCLUSIONS
  It is suggested that guidelines aimed at reducing unnecessary hysterctomies should be put in place and implemented. This will go a long way in improving the justification rate for hysterectomies at our centre, save clients resources, improve client satisfaction and quality of care.
authors.affiliation: Department of Pathology, University of Calabar Teaching Hospital, Calabar.
authors.forename: I E
authors.initials: IE
authors.lastname: Bassey
authors.forename: A N
authors.initials: AN
authors.lastname: Gyuse
authors.forename: P O
authors.initials: PO
authors.lastname: Odusholu
authors.forename: I A
authors.initials: IA
authors.lastname: Ekanem
authors.forename: A J
authors.initials: AJ
authors.lastname: Omotoso
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D008485:Medical Audit; D008875:Middle Aged; D009549:Nigeria; D009774:Obstetrics; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D014599:Uterus / Q000473:pathology / Q000601:surgery