MyMedR

Fulltext Hysterectomies in Malaysia: why are we left behind?

Teoh TGK

Med J Malaysia, 1999 Mar;54(1):151-2.

PMID: 10972021

Matched MeSH terms: Hysterectomy*

A plea against abdominal hysterotomy in the treatment of hydatidiform mole

Chan DP

Med J Malaya, 1965 Sep;20(1):36-8.

PMID: 4221409

Matched MeSH terms: Hysterectomy*

Ethical issues in laparoscopic hysterectomy

Hebbar S, Nayak S

Indian J Med Ethics, 2006 Jan-Mar;3(1):19-20.

PMID: 16832925

Hysterectomy is performed for a wide range of benign and malignant conditions, such as fibroids, menorrhagia and pelvic pain, and gynaecological malignancies. One in four women has a chance of undergoing hysterectomy in her lifetime. Conventionally abdominal hysterectomy is done through the open approach. However, many patients assume that the modern laparoscopic hysterectomy is superior to the standard approach. Laparoscopic surgical centres are mushrooming in major cities. This article presents ethical considerations involved in the decision-making process of choosing from the surgical options available.

Matched MeSH terms: Hysterectomy/methods*; Hysterectomy/ethics*

Fulltext Vaginal hysterectomy for the large uterus

Teoh TGK

Med J Malaysia, 2001 Dec;56(4):460-2.

PMID: 12014766

Vaginal hysterectomy for the large uterus is seldom performed in Malaysia. The traditional operation is abdominal hysterectomy. This is a personal series of vaginal hysterectomies for enlarged uterus of more than 12 weeks size (>280g) carried out in a private hospital between 1/1/97 to 30/9/2000. A total of 40 cases were done with the weights of the uterus ranging from 290g to 790g. The mean weight of the uterus was 434g. The average operating time was 92.1 min. The complications were minimal with 2 cases of blood transfusion for intra-operative hemorrhage, 1 case of fever and 1 case of bladder perforation. This series demonstrates feasibility and safety of the operation. The excellent recovery due to the absence of an abdominal scar should be a strong incentive for specialists to learn the skill.

Matched MeSH terms: Hysterectomy, Vaginal*

Fulltext Outcome of vaginal hysterectomy for the undescended and enlarged uterus--a preliminary report

Teoh TGK

Med J Malaysia, 1996 Dec;51(4):415-9.

PMID: 10968027

This is a retrospective observational study of outcome of 11 cases of vaginal hysterectomy for undescended and enlarged uterus carried in University Hospital, Kuala Lumpur. The cases included relative contraindications such as 14 weeks size fibroids, severe obesity, previous Caesarean section and nulliparity. All the eight patients agreeable for prophylactic bilateral salpingoophorectomy had their ovaries removed. Operative time ranged from 1 hr 20 min to 2 hr 15 min. All patients were sent home within 48 hours of the operation. The excellent outcome of our initial experience highlights the known advantages of vaginal hysterectomy for undescended and enlarged uterus.

Matched MeSH terms: Hysterectomy, Vaginal*

An evaluation of the vaginal hysterectomy-repair operation for utero-vaginal prolapse

Cheng M

Med J Malaya, 1971 Sep;26(1):56-8.

PMID: 4258577

Matched MeSH terms: Hysterectomy*

Physical, psychological and sexual effects in multi-ethnic Malaysian women who have undergone hysterectomy

Wong LP, Arumugam K

J Obstet Gynaecol Res, 2012 Aug;38(8):1095-105.

PMID: 22540215 DOI: 10.1111/j.1447-0756.2011.01836.x

The postoperative effects on Asian women after hysterectomy have not been fully explored. This study was undertaken to investigate the physical, psychological and sexual functioning effects in multi-ethnic Malaysian women who have undergone hysterectomy.

Matched MeSH terms: Hysterectomy/adverse effects; Hysterectomy/psychology*; Hysterectomy/statistics & numerical data

Long-term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Lo TS, Pue LB, Hung TH, Wu PY, Tan YL

J Obstet Gynaecol Res, 2015 Jul;41(7):1099-107.

PMID: 25808989 DOI: 10.1111/jog.12678

To evaluate and compare the long-term outcome of sacrospinous ligament fixation (SSF) in combination with various other compartment defect native tissue repairs with hysterectomy or hysteropexy.

Matched MeSH terms: Hysterectomy

The place of vaginal hysterectomy in the management of genital prolapse

Menon R

Med J Malaya, 1970 Mar;24(3):194-5.

PMID: 4246800

Matched MeSH terms: Hysterectomy

Hysterectomy in a phenotypic male with congenital adrenal hyperplasia (CAH)

Aziz NA, Mohd Ali MH, Ramli R

BMJ Case Rep, 2022 Feb 08;15(2).

PMID: 35135794 DOI: 10.1136/bcr-2021-246603

A young adult patient with 46XX congenital adrenal hyperplasia (CAH) presented with recurrent painful haematuria. CAH was diagnosed at birth following ambiguous genitalia. Hormonal treatment was started, female gender was assigned and feminising genitoplasty was planned, however the patient was lost to follow-up. Gender dysphoria started to occur during childhood which prompted the family to raise the patient as a boy. He eventually identified himself as a male. Examination revealed a male phenotype with severely virilised genitalia. Imaging studies confirmed the presence of uterus with low confluent urogenital sinus. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and the troublesome symptoms were cured.

Matched MeSH terms: Hysterectomy

Fulltext A survey of hysterectomy patterns in Malaysia.

Ravindran J, Kumaraguruparan M

Med J Malaysia, 1998 Sep;53(3):263-71.

PMID: 10968164

A prospective cross-sectional study involving 14 government hospitals was undertaken for a period of 6 months in Malaysia to study the patterns of hysterectomy for gynaecological indications. A total of 707 patients were enrolled in the study consisting of 612 abdominal hysterectomies and 95 vaginal hysterectomies. Fibroids (47.6%) and uterovaginal prolapse (13.4%) formed the main indications for surgery. The initial preoperative diagnosis was accurate in 82.8% of cases. A different pathology from that initially suspected was noted in 118 cases. The overall complication rate was 7.9% but vaginal hysterectomies carried a statistically higher complication rate compared to abdominal hysterectomies. Urinary tract infection was significant in vaginal hysterectomies. Blood transfusion was required in 25.0% of abdominal and 6.3% of vaginal hysterectomies. There were no laparoscopic hysterectomies or mortality in this series.
Comment in: Soh EB, Ng KB. A survey of hysterectomy patterns in Malaysia. Med J Malaysia. 1999 Mar;54(1):152-4; Teoh TG. Hysterectomies in Malaysia: why are we left behind? Med J Malaysia. 1999 Mar;54(1):151-2

Matched MeSH terms: Hysterectomy/adverse effects*; Hysterectomy, Vaginal/adverse effects

Fulltext Epidural buprenorphine and bupivacaine in major gynaecological operations

Loh SP

Med J Malaysia, 1993 Jun;48(2):207-10.

PMID: 8350797

Eight patients underwent major gynaecological operations. Their post-operative analgesia was provided by epidural buprenorphine 0.15 mg and bupivacaine 0.5%. The efficacy and side-effects of this combination were assessed. All patients had satisfactory analgesia ranging in duration from 10 hours to greater than 36 hours after a single dose injection. No significant side-effect was noted.

Matched MeSH terms: Hysterectomy*

Uterine bleeding with an IUD requiring emergency hysterectomy

Glew S, Singh A

Adv Contracept, 1989 Mar;5(1):51-3.

PMID: 2782134

A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed.

Matched MeSH terms: Hysterectomy*

Fulltext Magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment for uterine fibroids

Abdullah B, Subramaniam R, Omar S, Wragg P, Ramli N, Wui A, et al.

Biomed Imaging Interv J, 2010 Apr-Jun;6(2):e15.

PMID: 21611036 MyJurnal DOI: 10.2349/biij.6.2.e15

Magnetic Resonance-guided focused Ultrasound Surgery (MRgFUS) is gaining popularity as an alternative to medical and surgical interventions in the management of symptomatic uterine fibroids. Studies have shown that it is an effective non-invasive treatment with minimal associated risks as compared to myomectomy and hysterectomy. MRgFUS can be offered to a majority of patients suffering from symptomatic uterine fibroids. It has been suggested that the use of broader inclusion criteria as well as the mitigation techniques makes it possible to offer MRgFUS to a much larger subset of patients than previously believed. This paper will describe how MRgFUS treatment for uterine fibroids is performed at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia.

Matched MeSH terms: Hysterectomy

Fulltext Laparoscopic Wedge Resection in a Late Second Trimester Cornual Pregnancy

Safiee AI, Ghazali WAHW

Gynecol Minim Invasive Ther, 2021 01 30;10(1):47-49.

PMID: 33747774 DOI: 10.4103/GMIT.GMIT_22_19

Cornual pregnancy happens when implantation occurs in the cavity of a rudimentary horn of the uterus, which may or may not be communicating with the uterine cavity. The diagnosis of cornual pregnancy remains challenging, and rupture of a cornual pregnancy usually causes massive bleeding. Early diagnosis and treatment, therefore, are very crucial and key to prevent mortality. Historically, the management of cornual pregnancies included wedge resection through open surgery or even hysterectomy. In this case report, we would like to highlight a case of late second trimester cornual pregnancy, at 19-week and 3-day gestation, which was managed laparoscopically.

Matched MeSH terms: Hysterectomy

Fulltext An Unusual Presentation and Behaviour of Endometrial Stromal Sarcoma

Adibah, I., Wan Abu Bakar, W.Y., Nik Mohamed Zaki, N.M., Nik Hazlina, N.H., Venkatesh, R.N.

International Medical Journal Malaysia, 2006;5(2):1-4.

MyJurnal

Endometrial stromal sarcoma is a rare tumour of the uterus. We reported a case of a young lady with endometrial stromal sarcoma. She became pregnant while having the disease and delivered a healthy baby, her sixth, without any complication. A total abdominal hysterectomy with bilateral oopherectomy was performed subsequently. She refused any added treatment after the operation. To date, she is free of any recurrence.

Matched MeSH terms: Hysterectomy

Fulltext Post partum vulvo-vaginal haematomas and options of management

Lim, P.S., Muhammad Abdul Jamil, M.Y, Zainul, R.A.Z, Mohd Hashim O., Rozman, Z., Shafiee, M.N., et al.

Journal of Surgical Academia, 2011;1(1):52-55.

MyJurnal

Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.

Matched MeSH terms: Hysterectomy

Fulltext Role of hysterectomy in chemoresistant gestational trophoblastic neoplasia

Sum YY, Sim WW, Yu KL, Melee T, Voon PJ

Med J Malaysia, 2018 10;73(5):332-333.

PMID: 30350817 MyJurnal

No abstract provided.

Matched MeSH terms: Hysterectomy

Peripartum hysterectomy clinical characteristics and outcomes- a hospital based retrospective audit study

Nor AM, Jagdeesh K, Mohd FAS, Kamraul AK, Yusmadi A, Noraslawati R, et al.

Med J Malaysia, 2023 Nov;78(6):756-762.

PMID: 38031217

INTRODUCTION: The study aims to evaluate and report on the clinical characteristics, incidence, risk factors and associated complications of emergency and planned peripartum hysterectomy in a single training and research tertiary health care centre in Malaysia.

MATERIALS AND METHODS: We conducted a 6-year retrospective cross-sectional study from the 1st January 2016 until 31st December 2021. Clinical, demographic characteristics, perioperative parameters, operative indications, blood loss, maternal/neonatal outcomes and complications were analysed. Patients were subdivided, analysed and studied in two subgroups- emergency hysterectomy (EH) and planned hysterectomy (PH).

RESULTS: There were 65 cases of peripartum hysterectomy out of total 100,567 deliveries, with a prevalence rate of 0.06%. Overall, the majority of patients were multiparous (96.9%), having previous caesarean scar (73.8%) or diagnosed with placenta praevia (75.4%). More than half of the total patients (61.5%) have both previous caesarean scar and concomitant placenta praevia. EH was carried out in 39(60%) patients while 26(40%) patients underwent PH. The only indication for surgery in the PH group (100%) was abnormal placentation while the most common indication for surgery in the EH group (53.8%) was postpartum haemorrhage related to abnormal placentation. Patients who underwent EH were more likely to have massive blood loss (p=0.001), require ICU admissions (p=0.001), have DIVC cycles transfused (mean [SD] regime: 1.35 [0.95] vs 0.54 [0.99]; p=0.002), have lower postoperative haemoglobin level (mean [standard deviation, SD] haemoglobin: 9.23g/l [SD1.8] vs. 10.8 g/l [SD1.86]; p=0.001) and have higher difference between pre/post operative haemoglobin level (mean [SD] haemoglobin difference: 1.78g/l [SD6.34] vs 0.32g/l [SD1.7]; p=0.008) compared to patients with PH. Red blood cell transfusion, operating time, length of stay, weight of babies and Apgar score between two groups showed no significant differences. A significant reduction of blood loss between the first and the second half duration of the study (mean [SD] blood loss: 6978 ml [SD 4999.45] vs. 4100ml [SD2569.48]; p=0.004) was also observed. In the emergency group, 'non-placental cause' EH required significantly more red blood cell transfusion than 'placental cause' (p<0.05) while in the PH group, no significant difference was observed between the occlusive internal iliac artery 'balloon' and 'no balloon' subgroup in terms of operating time, total blood loss or blood transfusion. Overall complications showed more cases of post operative fever and relaparotomy in the EH group (18.4% vs. 7.6%) while urinary tract injuries including injuries to bladder and ureter occurred only in the PH group (9.4% vs. 0%).

CONCLUSION: The majority of peripartum hysterectomy cases are due to placenta accreta spectrum disorders. Planned peripartum hysterectomies have a lower morbidity rate compared to emergency hysterectomies. Therefore, early identification of placenta accreta spectrum disorders and timely planning for elective procedures are crucial to minimise the need for emergency surgery.

Matched MeSH terms: Hysterectomy/adverse effects; Hysterectomy/methods

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles

Thavarasah AS, Kanagalingam S

Aust N Z J Obstet Gynaecol, 1988 Aug;28(3):233-5.

PMID: 3233084

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Matched MeSH terms: Hysterectomy

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