Background: Hysterectomy is one of the most commonly performed definitive treatment for various gynecological diseases worldwide. In this study we aim to analyze the hysterectomies done in our hospital with respect to age, indications, routes of hysterectomies, complications and histopathological correlation with clinical findings. Material and Methods: This prospective, observational study was conducted on total of 579 patients in the Department of Obstetrics & Gynecology, Pacific Medical College & Hospital, Rajasthan. Clinical diagnosis was established on the basis of history, clinical examination and investigations which included ultrasound, Pap’s smear and endometrial biopsy if done. All hysterectomy specimens were subjected to histopathological examination. Sensitivity, specificity, positive predictive value, negative predictive value and p-value of clinical diagnosis with histopathological diagnosis was calculated. Results: The commonest indication of hysterectomies in our hospital was abnormal uterine bleeding (26.94%). Total abdominal hysterectomy with bilateral salpingoophorectomy was the most common procedure with an incidence 74.27%. The overall sensitivity was 90.36%, specificity was 98.6% and positive predictive value was 85.9% in our study. The accuracy of the diagnosis ranged from 89.6 % to 100% and p - value was significant at 0.001 for adenomyosis and proliferative endometrium. In all cases of malignancies and cervical dysplasia p value was insignificant because all malignancies can be diagnosed clinically and histopathology is for confirmation and further management. Conclusion: Every hysterectomy specimen should be subjected to histopathological examination to ensure diagnosis and further management in particular of malignant diseases. Histopathological analysis correlates well with the pre-operative clinical diagnosis for hysterectomy.

Keywords: Clinicopathological; Histopathological Diagnosis; Hysterectomy; Adenomyosis; Total Abdominal Hysterectomy.