Prevalence and Outcome of Total Abdominal Hysterectomy Performed for Cervical Intraepithelial Neoplasia in Benin City

Background: Cervical cancer is the commonest malignancy of the female genital tract in developing countries. A preventable disease with a precursor; cervical intraepithelial neoplasia (CIN), is detected by screening methods and it is treated by the use of ablative or excisional methods. Nonetheless, the incidence and death from cervical cancer have continued to rise in developing countries due to a lack of screening programs/follow up.

Aims: The study looked at the recourse to total abdominal hysterectomy (TAH) with CIN as the primary indication at the University of Benin Teaching Hospital as well as the outcome of surgery and observed complications.

Methodology: This was a 4-year retrospective cross-sectional, analytical study that was conducted on 145 women who underwent TAH for benign gynaecological conditions. Relevant data were extracted from case notes and hospital records. Analysis was performed using SPSS version 22.

Results: A total of 145 cases were analysed and the prevalence of TAH for CIN (n = 25) was 17.2%. Uterine fibroids contributed the highest prevalence for TAH at 51% followed by endometrial hyperplasia at 22.8%. The mean age distribution was 47.2 years and 96.6% were parous. The commonest adverse surgical outcome was haemorrhage, followed by a prolonged hospital stay.

Conclusion: Hysterectomy remains the most effective treatment for CIN. With the advent of effective ablative and excision procedures, it is considered overkill in developed countries. However, the lack of skills and equipment for these procedures and loss of follow-up in developing countries make hysterectomy a viable treatment modality for CIN.