Background: Rates of hysterectomy differ according to geographic distribution and practice patterns of the local gynaecologic surgeons This was a retrospective study in which the histopathological examination (HPE) of the specimens of all the hysterectomies done in Silchar Medical College & Hospital, Assam, India from January 2016 to December 2017, were analysed. The aim of the study was to assess the range of pathological lesions in the hysterectomy specimens and correlation of the preoperative diagnosis with the histopathological diagnosis.

Methods: This was a retrospective study which was conducted at the Department of Pathology, Silchar Medical College & Hospital, Silchar, Assam, India and incorporated all hysterectomy cases over a period of 24 months, from January 2016 to December 2017.

Results: A total of 446 hysterectomies were done during the study period. Among these, 278(62.3%) were abdominal and 168(37.7%) were vaginal hysterectomies. Mean age of the patients were 45.1 years. Uterovaginal prolapse (36.8%) was the most common preoperative indication overall, while uterine fibroid (22.6%) was the commonest indication for abdominal hysterectomies. Other common indications were ovarian mass (12.5%), dysfunctional uterine bleeding (DUB)(12.1%) and adenomyosis (9.2%). Fibroid uterus in the myometrium, chronic cervicitis in the cervix and functional cysts in the ovaries were the most common histopathology noted. Patients operated with a preoperative diagnosis of DUB had the least HPE correlation. Findings were unremarkable in 30.5%   cases.

Conclusion: Justification of hysterectomy is demonstrated when the HPE report is compatible with the preoperative diagnosis; hence HPE of all hysterectomy specimens ought to be performed.