The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

Sakko Y. Aimagambetova G. Terzic M. Ukybassova T. Bapayeva G. Gusmanov A. Zhakhina G. Zhantuyakova A. Gaipov A.
November 2022 MDPI

International Journal of Environmental Research and Public Health
2022 #19 Issue 22

Objectives: Major gynecological surgeries are indicated for the treatment of female genital pathologies. It is key to examine trends in gynecologic surgical procedures and updated recommendations by international gynecological societies to find opportunities for improvement of local guidelines. To date, a very limited number of reports have been published on the epidemiology of gynecological surgeries in Kazakhstan. Moreover, some local guidelines for gynecological conditions do not comply with the international recommendations. Thus, this study aims to investigate the prevalence, indications, and outcomes of the most common major gynecological surgeries by analyzing large-scale Kazakhstani healthcare data, and identifying possible opportunities for improvement of the local public health and clinical practice. Methods: A descriptive, population-based study among women who underwent a gynecological surgery in healthcare settings across the Republic of Kazakhstan during the period of 2014–2019 was performed. Data were collected from the Unified Nationwide Electronic Health System (UNEHS). Results: In total, 80,401 surgery cases were identified and analyzed in the UNEHS database for a period of 6 years (2014–2019). The median age of the participants was 40 years old, with 61.1% in reproductive age. The most prevalent intervention was a unilateral salpingectomy—29.4%, with 72.6% patients aged between 18–34 years. The proportion of different types of hysterectomies was 49.4%. In 20% of cases, subtotal abdominal hysterectomy was performed due to uterine leiomyoma. The proportion of laparoscopic procedures in Kazakhstani gynecological practice is as low—11.59%. Conclusions: The Kazakhstani public health and gynecological care sector should reinforce implementation of contemporary treatment methods and up-to-date policies and guidelines. The overall trends in surgical procedures performed for gynecological pathologies, including uterine leiomyoma and ectopic pregnancy treatment, should be changed in favor of the minimally invasive methods in order to adopt a fertility-sparing approach.

epidemiology , hysterectomy , Kazakhstan , oophorectomy , public health , salpingectomy , salpingo-oophorectomy

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Department of Medicine, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana, 010000, Kazakhstan
Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, 300 Halket Street, Pittsburgh, 15213, PA, United States
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
Clinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, 010000, Kazakhstan

Department of Medicine
Department of Biomedical Sciences
Clinical Academic Department of Women’s Health
Department of Obstetrics
Department of Obstetrics and Gynecology
Clinical Academic Department of Internal Medicine

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