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Survey of patients undergoing hysterectomy for a clinical audit of histopathological patterns in the hysterectomy specimens and their correlation with clinical findings.
Dear Madam, please take a few minutes of your time to complete the following questionnaire.
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1
What is the patient's age?
Please select the age range of the patient.
Under 30
31-40
41-50
51-60
Over 60
2
Indication for Hysterectomy
Select the primary indication for hysterectomy.
Fibroids
Endometriosis
Cancer
Adenomyosis
Other
3
Type of Hysterectomy
Choose the type of hysterectomy performed.
Total Abdominal Hysterectomy
Total Vaginal Hysterectomy
Laparoscopic Hysterectomy
Robotic Hysterectomy
4
Intraoperative Complications
Did any intraoperative complications occur?
Yes
No
5
Perioperative Blood Transfusion
Was a blood transfusion required during the surgery?
Yes
No
6
Postoperative Complications
Were there any postoperative complications?
Yes
No
7
Histopathological Diagnosis
What was the histopathological diagnosis post-surgery?
8
Histopathological Findings - Endometrium
Describe the findings related to the endometrium.
9
Histopathological Findings - Myometrium
Describe the findings related to the myometrium.
10
Histopathological Findings - Cervix, Ovaries, and Fallopian Tubes
Describe the findings related to the cervix, ovaries, and fallopian tubes.
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