TEMPLATE DESIGN © Objectives Methods This was a retrospective cohort data analysis of all women who presented with menorrhagia and or pelvic pain that resulted to hysterectomy, from January 2008 to December 2010 in a multi- cultural community. Patient’s characteristics, indication for hysterectomy, previous treatment(s) offered, patient counselling, provision of information leaflet, route of hysterectomy, histological findings, and post operative complications were analysed. Patient information was extracted from the theatre database and notes. All hysterectomies performed for suspected malignancies and vaginal prolapse were excluded. Results A total of 186 women underwent hysterectomy during the 2 year period. The median age was 45 years old. Indication for Hysterectomy were; A failed or combined failure of medical and mirena or ablation technique Recurrent symptoms after myomectomy or uterine artery embolisation. Ultrasound scan showed fibroids in 77% of cases. Table 1 showed route of hysterectomy A total of 48 (25%) oophorectomies were performed. Histology reports confirmed 78% fibroids, 10% Adenomyosis 12% normal uterus. There were 5% (10) conversion rate to open hysterectomies: Laparoscopic (3) Vaginal (7). There was no major complication Twenty (11%) women required blood transfusion. The estimated blood loss range was mls Specimen weight range from 500 to 7800 grams Length of hospital stay range from 5 to 9 days. Conclusions Our study demonstrates that more women could be offered the laparoscopic route of surgery for benign condition such as dysfunction uterine bleeding, fibroid uterus less than 14 weeks size. Conversion rate was higher with vaginal route secondary to fibroid uterus. Laparoscopic approach represents the best option among possible routes for an improvement in the patient's quality of life. OPTIONAL LOGO HERE Barts Health NHS Trust Hysterectomy for benign gynaecological conditions: Our experience in a teaching hospital O. Olowu, T. Palamarchvk, Q. S. Naquib, N. Agarwal, F Odejinmi Department of Obstetrics and Gynaecology. Whipps Cross University Hospital, London, Uk OpenLaparosc opy Vaginal Hysterectomy n (%) 95(51) 73(39)18(10) Specimen weight (gm) Length of stay (days) Blood transfusion1037 Oophorectomy unilateral or bilateral Table 1: Type of hysterectomies N=186 To assess the route of surgery as a final option in the management of women presented with menorrhagia, proportion of pre-operative treatment offered and postoperative complications Background Hysterectomy is the most prevalent gynaecological surgeries worldwide Over 90% of hysterectomies are performed for benign conditions that are not life threatening but have a negative impact on quality of life Menorrhagia is the primary indication and is not always a response to an anatomical uterine disease. Many institutions recommend abdominal hysterectomy (AH) only when the vaginal or laparoscopic route is ruled out [1] Scientific evidence favours Vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH), which have lower complication rates, produce less postoperative pain and shorter hospital stays, and allow a more rapid return to normal activity, thereby resulting in a better quality of life [2-4] Reference 1.Kovac SR. Guidelines to determine the route the route of hysterectomy. Obstet. Gynecol. 85,18–23 (1995). 2.Summitt RL Jr, Stovall TG, Steege JF, Lipscomb GH. A multicenter randomized comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy in abdominal hysterectomy candidates. Obstet. Gynecol. 92,321–326 (1998). 3.Kovac SR. Hysterectomy outcomes in patients with similar indications. Obstet. Gynecol. 95,787–793 (2000). 4.Van den Eeden SK, Glasser M, Mathias SD, Colwell HH, Pasta DJ, Kunz K. Quality of life, health care utilization, and cost among women undergoing hysterectomy in a managed-care setting. Am. J. Obstet. Gynecol. 178,91–100 (1998).