Hysterectomy for Gynecological Indication in six Medical Facilities in Lubumbashi/DRC Frequency, Indications, Early Operative Complications

The objective of the present study was to determine the frequency of hysterectomies for gynecological indications, to highlight the sociodemographic aspect of the patients, to specify the indications, to determine the early operative complications and to identify the factors associated with these hysterectomies. Material and methods: This is a cross-sectional, retrospective descriptive study with an analytical aim; from January 2013 to December 2017, i.e. a period of 5 years. We collected a total of 266 hysterectomies operated for gynecological pathologies. The analyzes were carried out with the JPM pro version 2018 software. Results: Thus taking into account all major gynecological surgical interventions, the frequency was 22.52% and 4.00% considering all gynecological and obstetrical surgical activities. The indications were dominated by myomas (41.40%), followed by cervical cancer (24.80%). The most frequently encountered intraoperative incident was haemorrhage (19.2%) and the predominant postoperative complication was parietal infection (12.41%). In 93.60% of cases, gynecological hysterectomies were performed through the abdominal route. Compared to the associations: Age between 31 and 40 years multiplied by 3 the risk of undergoing a hysterectomy for myoma, OR: 2.6 (1.3-7.7) and age between 41 and 50 years multiplied this risk by 5, OR : 4.5 (2.5-8.0). Nulliparity increased the risk of undergoing hysterectomy for myoma 142-fold, OR: 141.8 (28.3- 708.5); primiparity multiplied this risk by 81 OR: 80.5 (18.16-303) and pauciparity by 21, OR: 21.0 (7.8-56.2). Conclusion: Gynecological hysterectomy remains a fairly frequent act in our environment, burdened with significant morbidity. It is necessary to improve the technical platform and the training of operators.