A STUDY ON CORRELATION BETWEEN PRE OPERATIVE CLINICAL DIAGNOSIS AND POST OPERATIVE PATHOLOGICAL DIAGNOSIS IN PATIENTS UNDERGOING TOTAL ABDOMINAL HYSTERECTOMY

Abstract

Introduction: The present study addresses the correlation between preoperative clinical diagnosis and postoperative pathological diagnosis in patients undergoing total abdominal hysterectomy (TAH) for benign gynecological conditions. Hysterectomy remains one of the most common surgical procedures among women, with total abdominal hysterectomy being frequently performed despite the availability of less invasive alternatives. Accurate preoperative diagnosis is critical for optimal surgical planning and patient management, especially for conditions like adenomyosis which pose diagnostic challenges. Objectives: The primary objective of the present study is to determine the histopathological diagnosis of TAH specimens and to correlate these findings with preoperative clinical diagnoses, thereby assessing the accuracy and reliability of clinical evaluation in guiding surgical intervention. Methodology: This prospective observational study was conducted at KMCT Medical College, Kozhikode, Kerala, from 2022 to 2025. A total of 100 patients undergoing TAH for benign indications were enrolled using consecutive sampling. Data collection included demographic details, clinical history, imaging findings, intraoperative observations, and postoperative histopathological examination performed by a single pathologist. Statistical analysis involved descriptive statistics and Pearson correlation to assess concordance between clinical and pathological diagnoses, with significance set at p < 0.05. Results: The study population predominantly comprised women aged 41–50 years (76%), with multiparity (P2L2) in 55%. Heavy menstrual bleeding was the chief complaint (64.36%). Leiomyoma was the most common clinical diagnosis (61%), followed by fibroid uterus (30%) and adenomyosis (17%). Histopathology confirmed leiomyoma (70%) and adenomyosis (34%) as leading pathologies. Correlation rates were highest for hyperplasia (100%) and leiomyoma (87.14%), while adenomyosis showed a lower correlation (50%). Total abdominal hysterectomy with bilateral salpingo-oophorectomy was the predominant surgical procedure (73%), with minimal postoperative complications. Conclusion: The present study demonstrates strong concordance between preoperative clinical diagnosis and postoperative histopathological findings for most benign uterine conditions, validating clinical and imaging assessments for leiomyoma and hyperplasia. The lower diagnostic accuracy for adenomyosis underscores the need for enhanced preoperative diagnostic tools. Routine histopathological examination remains essential to confirm diagnoses and guide postoperative management. These findings support comprehensive preoperative evaluation combined with histopathological confirmation to optimize patient outcomes in total abdominal hysterectomy.