What are the risks of surgery?

Surgery can be extremely effective but it is not free from risk. The risk may be small but should be balanced against the likely benefits. Complications can occur:-

at the time of surgery or within the first twenty-four hours
during the next days or few weeks (intermediatein the long-term.

There could be bleeding during the operation, within the first 24 hours of the operation (primary haemorrhage) requiring a return to the operating theatre or bruising or collection of blood over the next few days (secondary haemorrhage). A surgical cut results in scarring which could result in long-term discomfort. The objective of the operation may not be achieved. There may be specific recognised complications for particular operations. An example of a long-term psychological complication is regret at having been sterilised.

Some complications are local such as:

Wound infection.

There is always a tiny chance of an accidental or unavoidable injury however competent and careful the surgeon may be.

Other complications may be of a more general nature:

A general anaesthetic carries by itself a small risk; chest infection or breathing difficulties for example may occur.

A clot may occasionally form in a leg vein (deep venous thrombosis (DVT) and if it is dislodged it may travel to the lung (pulmonary embolism). The risk of this complication is increased:

if you are overweight
if there is a history of previous thrombosis or embolism.
With more complex and time consuming surgical procedures
when there is delay in post-operative mobilisation.

The risks of surgery have fallen dramatically over the last century. A number of factors are responsible for this:

Aseptic technique has reduced the risk of infection.
We have powerful antibiotics should infection occur.
There has been a tendency to administer antibiotics at the time of surgery to reduce infection.
Anaesthetics are administered by highly trained and skilled doctors.
Surgical techniques have become ever more refined.
Blood-cross matching and transfusion is refined and remarkably safe.

Every choice in life is a matter of balancing the advantages and the disadvantages. frequently, the advantages of surgery clearly outweigh a conservative approach. Appendicitis or life-threatening bleeding are obvious examples. The decision to operate for the majority of operations, however, is influenced by the severity of symptoms. In gynaecology, laparoscopy to assess pelvic pain (laparoscopy), hysterectomy (hysterectomy) for heavy periods (Q 24.5) and pelvic floor repair for vaginal prolapse (6) are examples. If you have a recurring pain that does not require even a paracetamol tablet it is unlikely that you will require an operation to determine the cause or remove the source of the pain the risks of surgery are likely to be greater than the possible benefits. If your periods are limiting your enjoyment of life, your family is complete, and other treatments are not helping, the benefits of hysterectomy are likely to outweigh the risks.

Women's Health

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.