Hysterectomy in Adolescents, in Port Harcourt, Nigeria
Background: Hysterectomy in adolescents is a very difficult decision to take as the consequence is always a loss of future reproductive potential. However, it may be necessary sometimes as a salvage measure.
Methods: A retrospective descriptive analysis of 28 cases of adolescent hysterectomies managed at the University of Port-Harcourt (UPTH) over a 17-year period was carried out. Variables analysed included socio-demographic factors, indications for and type of hysterectomy performed, decision level, duration of surgery and complications encountered.
Results: Majority (78%) of the hysterectomies were in adolescents aged 16 years and above. Sixty percent of them had a secondary education, 78% were unmarried and nine had a previous successful pregnancy. About half the cases resided in rural areas, while half resided in urban settlements. Seventy-one percent of the hysterectomies were abortion- related. Decisions for the hysterectomies were taken mainly by consultants and occasionally, in dire emergencies, by senior residents to prevent death from bleeding. Mortality was 21%.
Conclusion: The results suggest the need for a greater emphasis on sexuality education and expansion of sexual and reproductive health services to adolescents especially those who are sexually active. Life planning and livelihood skills training are needed to enable young people acquire value- based skills, which are essential for making safe and informed choices. With such high level of mortality from septic abortion even with intervention, the need for Youth Friendly Centre’s/services cannot be over emphasized.
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