Systematic review of medical audits of hysterectomy practices in India.

TL;DR

This systematic review of 89 Indian hospital audits (2010–2024) found hysterectomies are predominantly performed for benign conditions—particularly fibroids and abnormal uterine bleeding—often in premenopausal women, with frequent oophorectomy without documented ovarian pathology and significant gaps in standardized reporting.

Key findings

• Hysterectomies predominantly performed in premenopausal women, with ~25% under age 40, for benign indications (fibroids, abnormal uterine bleeding)
• Abdominal approach predominated despite availability of alternatives; oophorectomy frequently performed without documented ovarian pathology
• Common complications included hemorrhage, postoperative fever, and urinary tract infections
• Substantial gaps identified in standardized reporting, clinicopathological documentation, and adherence to India's National Guidelines for surgical indications and extent

Why this matters at the bedside

Highlights overuse of hysterectomy in benign disease among younger women in India and poor adherence to evidence-based guidelines; identifies need for audit strengthening, conservative/minimally invasive alternatives, and standardized documentation to improve quality of care and reduce unnecessary surgery.