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Complications of Hysterectomy
General Surgery / Aug 2nd, 2016 6:53 am     A+ | a-
A hysterectomy is largely a low-risk surgical procedure. The most common complications of hysterectomy may be classified as follows:
These are the most common, and vary with the type of hysterectomy. Thus a vaginal hysterectomy is followed by some kind of infectious complication in up to 13 percent of patients, but only 9 percent after a keyhole surgery.
Venous thromboembolism
Though laboratory tests show that up to 12 percent of patients have a clotting episode, clinical symptoms occur in only 1 percent. Early ambulation and prophylactic anticoagulants are associated with a lowering of the risk for such events.
Injury to the genitourinary (GU) and gastrointestinal (GI) tract
This may be estimated to occur in 0.5-0.6 percent of patients following a hysterectomy. The injury may occur to the ureter (1 percent), the bladder, or the rectum, and is usually repaired during the same procedure. Temporary colostomies or urinary catheters may have to be used in a few such cases to drain the orifice adequately during the period of healing. Difficulties would include incontinence, urgency of urination, or frequent infections.
This occurs rarely after such procedures, with transfusions being required more often after laparoscopic hysterectomy as compared to vaginal surgery. Median blood loss is less than 660, 287 and 568 mL in abdominal, vaginal and laparoscopic hysterectomy respectively.
Nerve injury
This is a significantly debilitating condition but fortunately rare, occurring in 0.2 to 2 percent of patients after a hysterectomy or other major pelvic surgery.
Vaginal cuff dehiscence
This occurs in less than 4 out of 100 patients, but more commonly following a total laparoscopic hysterectomy as compared to a laparoscopic-assisted procedure. The lowest rate is found in vaginal hysterectomy (0.08 percent).
Anesthetic complications
These are very rare, with serious complications occurring in only 1 of 10 000 cases of general anesthesia. These include the risk of neuropathy, allergy and death, the latter occurring in 1 in 100 000 patients. Generally fit patients have a very low risk of complications following anesthesia. Smoking, obesity and heart/lung infections carry the highest risk of anesthetic complications.
Ovarian failure
Within five years of the procedure, one or both ovaries may fail because of interruption to their blood supply following removal of the uterus. This may precipitate the symptoms of menopause. This may also lead to osteoporosis and ischemic heart disease in later life.
Low libido
All women do not respond the same way to the removal of the uterus. Some complain of less sexual enjoyment, perhaps due to the loss of uterine contractions or the sensation of pressure against the cervix. The removal of the ovaries may precipitate vaginal dryness and lack of sexual desire. Many patients regain full sexual pleasure once the couple adjusts to the new situation.
Some women complain of feeling depressed, either because of the loss of reproductive capacity or the feeling that they have lost an important part of their feminine personalities. Counseling with a professional or a group often helps, if the couple cannot handle it on their own.
The mortality rate following a hysterectomy ranges from 0.6 to 1.6 per 1000 procedures.
Which procedure?
Vaginal hysterectomies are associated with fewer complications than the abdominal procedure, probably due to the use of prophylactic antibiotics. However, the risk of unplanned major surgery, as for hemorrhage and repair of injuries to other organs is higher with vaginal hysterectomy (39 percent increase), especially following laparoscopically-assisted procedures (64 percent higher), as compared to abdominal procedures. Overall, it is likely to cause less fever, hemorrhage, hospitalization and convalescence.
The risk of complications, especially of post-operative hemorrhage which is the major one, decreases with age, and is 46 percent higher in the presence of fibroids. However, the risk of excessive bleeding was not less with age in patients undergoing hysterectomy for dysfunctional uterine bleeding.
The risk of complications doubles with laparoscopic procedures. However, patient selection and surgeon experience may affect this risk. Post-operative complications were most common in those who had operative problems, in those who were being operated upon for fibroids, women with serious illnesses and multiparous women.
Dr. Anil Gupta
Apr 26th, 2020 9:40 am
Great video of Complications of Hysterectomy. Thanks for posting this video! Absolutely amazing!!
Dr. Awad mahmud
May 17th, 2020 12:40 pm
AMAZING...really your video is helped me alot because i am struggling in Lap surgery's. This Great video of Complications of Hysterectomy really helped me thank you so much for the explanations.
May 21st, 2020 11:53 am
Great presentation of Complications of Hysterectomy. I am thankful for this educative lecture video is helping me a Lot's.
Dr. Sandesh
May 22nd, 2020 12:53 pm
Great presentation of Complications of Hysterectomy. I am thankful for this educative lecture video is helping me a Lot's.
Dr. Sanjay Gulati
Jun 12th, 2020 6:59 am
This is an amazing and very inspiring video of Complications of Hysterectomy I think I need to watch it at least once a day or certainly at those times that it all .just seems impossible. Thank you!
Dr Nitish Kumar Yadav
Jun 15th, 2020 8:52 pm
I feel like I’m in class with with Dr. Mishra. His teaching style is awesome. ..I have been looking at different sources to understand basic complications of the hysterectomy. This one made it all clear. Thank you so much. You are an amazing teacher...
Dr. Jamil Ismail
Jun 15th, 2020 8:59 pm
You’re such a great teacher. I have been so confused about the complications of hysterectomy surgery. but you made it so simple and very clear, better than my professor. You’re brilliant Dr. Mishra !!!! Thank you!
Tammy Herbst
Dec 5th, 2023 8:08 am
It's a very sick surgery to do this to woman...when there are plenty of alternatives ... regrets for's a life altering sick surgery...please God punish these objyns ns4sdt
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