SynthesisThe Indian journal of medical research2026
Systematic review of medical audits of hysterectomy practices in India.
Synthesis in The Indian journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background and objectives The utilisation of hysterectomy has emerged as a public health concern in India. The Ministry of Health's National Guidelines aim to reduce unnecessary hysterectomies by promoting adherence to recommended indications, age, and extent of surgery. Although audits are routinely conducted in tertiary hospitals, their findings have not been synthesised. We present a synthesis of medical audits of hysterectomy practices in India to identify patterns, gaps, and opportunities to improve the quality of care. Methods This systematic review included medical audits of hysterectomies in India published between 2010 and 2024 across PubMed, Scopus, and EMBASE. Using PRISMA guidelines, a systematic search and narrative synthesis were conducted to examine clinical indications, surgical route, complications, and histopathological correlations. Study selection and quality assessment were carried out independently by two reviewers using the Joanna Briggs Institute critical appraisal tool. Results The review included 89 medical audits, mostly of moderate quality. Hysterectomies were predominantly performed in premenopausal women, with one-fourth in women under 40 years. The leading indications were abnormal uterine bleeding and fibroids, commonly managed by abdominal surgery. Oophorectomy was frequently performed without documented ovarian pathology. Reported complications included haemorrhage, postoperative fever, and urinary tract infections. Interpretation and conclusions This review identified benign gynaecological conditions, particularly fibroids, as the predominant indication for hysterectomy. It also revealed substantial gaps in standardised reporting, clinicopathological documentation, and sociodemographic data. Strengthening audit systems, ensuring adherence to evidence-based guidelines, and expanding access to conservative and minimally invasive treatments are essential to support rational surgical decision-making and improve the quality of gynaecological care.
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