What are the risks of hysterectomy?
A hysterectomy is a commonly performed and generally safe surgical procedure. However, in order to make an informed decision and give your consent, you need to be aware of the possible side effects and the risk of complications. The recovery time post hysterectomy depends on the type of procedure, complications and the individual patient. Women who are overweight, for example, take longer to recover. Exercise and care with diet pre and post hysterectomy can speed up your recover. With laparoscopic hysterectomy, many women have made a complete recovery within 2-3 weeks. When discussing the pros and cons of hysterectomy with your gynaecologist you should take into account possible problems inclusding side effects and complications.
Complications
The risks of surgical procedures in general are discussed insurgery risks. This is when problems occur during or after the operation. The majority of women are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, infection or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Bleeding after hysterectomy occurring during the first 24 hours is called a primary haemorrhage and occurs if a ligature has slipped. Secondary bleeding after hysterectomy tends to occur about 10 days after surgery when the wound has become infected and eroded a vessel, usually quite a small one, but sometimes a larger one. One of the purposes of monitoring a patient immediatelay after an operation is to watch for primary haemorrhage by regularly recording the pulse and blood pressure.
Specific complications of hysterectomy are uncommon but can include damage to other organs and tissues in the abdomen, particularly the bladder and ureters (tubes that carry urine from the kidneys to the bladder). Further treatment such as returning to theatre to stop bleeding or to repair a damaged organ, antibiotics to treat an infection, or a blood transfusion to replace lost blood may be needed.
The urinary tract (bladder and ureters) are closely related to the uterus and may be damaged. The bowel is normally free from the uterus but may be adherent to it if there has been infection, endometriosis or previous surgery.
Infection in the urinary tract is a relatively common complication requiring antibiotics.
Thromboembolism (surgery risks) has been reduced by encouraging early mobilisation after surgery and the use of anticoagulants.
Bladder symptoms are common following hysterectomy. Antibiotics will help if there is infection. Otherwise these symptoms usually settle with time.
side effects
These are the unwanted, but mostly temporary effects of a successful procedure, for example, feeling sick as a result of the general anaesthetic.
After surgery (abdominal hysterectomy), you will have some pain, swelling and bruising in the abdomen area. These side effects usually clear up within a few days. You will have a permanently visible scar. Although this will be red and slightly raised to start with, it should soften and fade over the following weeks and months.
It is natural to worry that a hysterectomy might affect your sex life. For the majority of women hysterectomy does not diminish sexual activity or enjoyment. Some may be pleased that they can no longer conceive.
If your ovaries are removed, you may develop menopausal symptoms (see hysterectomy and the menopause) such as hot flushes and vaginal dryness. You would then need to consider hormone replacement therapy (HRT). If sexual intercourse becomes painful because your vagina is dry, local oestrogen or lubricants (available from most chemists) can help.
Related Medical Abstracts - Click on the paper title:-
- Psychosexual health 5 years after hysterectomy: population-based comparison with endometrial ablation for dysfunctional uterine bleeding. (2005-01)
- EVALUATE hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. (2004-01)
- Severe complications of hysterectomy: the VALUE study. (2004-02)
- EVALUATE hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. (2004-01)
- Hysterectomy: evolution and trends. (2003-01)
- The VALUE national hysterectomy study: description of the patients and their surgery. (2002-01)
- Hysterectomy for benign lesions in the north of France: epidemiology and postoperative events (2001-01)
- The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. (1987)
Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
Thank you for choosing to visit us.
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.
