What are the potential risks and complications associated with hysterectomy?

Tagged Hysterectomy; Posted 8 months ago by Andreas Obermair

A hysterectomy is a major surgical procedure, and like any surgery, it comes with potential risks and complications. The specific risks can depend on factors such as the type of hysterectomy (total, subtotal, or radical), the surgical approach (abdominal, vaginal, or laparoscopic), the patient's overall health, whether the patient had complex surgery previously and the reason (indication) for the surgery.

Some potential risks and complications include:

• Infection: Infections can occur at the incision site or within the pelvic cavity.
• Bleeding: Excessive bleeding during or after the surgery is a potential complication.
• Blood clots: There is a risk of blood clots forming, particularly in the legs (deep vein thrombosis) or lungs (pulmonary embolism).
• Anaesthesia risks: Some individuals may experience allergic reactions to anaesthesia, medications, or materials used during surgery.
• Damage to surrounding organs: In rare cases, nearby structures such as the bladder, ureters, or blood vessels may be inadvertently damaged during the surgery.
• Urinary issues: Some women may experience urinary problems, such as difficulty emptying the bladder or urinary incontinence.
• Bowel dysfunction: Changes in bowel habits or bowel function may occur. These are usually temporary.
• Pelvic pain: Some women may experience chronic pelvic pain after a hysterectomy.
• Vaginal vault prolapse: In cases of a total hysterectomy, where the cervix is removed, there is a risk of the upper part of the vagina descending into the vaginal canal.
• Complications related to laparoscopic surgery: If the hysterectomy is performed using a laparoscopic approach, there is a risk of an unplanned conversion to open surgery. In my hands, 98% of laparoscopic procedures get finished as those and only 2% of patients will require conversion to open.
• Organ injury: Whether surgery is open or laparoscopic there are risks associated with the use of instruments that can damage surrounding organs (bowel, bladder, ureters, blood vessels or nerves) and the insufflation of gas into the abdomen. This risk is severe if it develops but fortunately is rare (less than 1% in my hands).
• Psychological and emotional impact: Some women may experience emotional or psychological effects. The emotional impact can be significant for women of reproductive age undergoing a hysterectomy, as the procedure entails the loss of fertility.
• Hormonal changes: If the ovaries are removed during the hysterectomy, it results in surgical menopause, which can have hormonal and long-term health implications.

It's important for individuals considering a hysterectomy to discuss the potential risks and complications with their surgeon. The decision to undergo a hysterectomy should be based on a careful consideration of the benefits and risks, and alternatives should be explored when appropriate. Additionally, adherence to postoperative care and follow-up appointments is crucial to monitor and address any potential complications.

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