Hysterectomy
Risks of Hysterectomy
Hysterectomy poses some risks of major and minor complications. However, most women do not have complications after a hysterectomy.
Some studies have shown complication rates that are about the same for total laparoscopic hysterectomy (TLH), laparoscopically-assisted vaginal hysterectomy (LAVH), and total abdominal hysterectomy (TAH).9, 10 Your risk of problems after surgery may be higher or lower than average. This may depend in part on how experienced the surgeon is.
Major medical complications after hysterectomy
Rates of major complications after vaginal hysterectomy and abdominal hysterectomy (rounded to nearest 0.5%):8
Complications after hysterectomy Type of complication Vaginal hysterectomy (without laparoscopy) Abdominal hysterectomy (without laparoscopy) Heavy blood loss requiring blood transfusion
3%
2.5%
Bowel injury
0
1%
Bladder injury
1%
1%
Blood clot in lung (pulmonary embolism)
0
1%
Anesthesia problems (such as breathing or heart problems)
0
0
Need to change to abdominal incision during surgery
4%
0.5% (repeat incision)
Wound pulling open (dehiscence)
0
0.5%
Collection of blood (hematoma) at the surgery site needing surgical drainage
1%
1%
At least one major complication
9.5%
6%
In the study described above, the major complication rate was nearly twice as high after laparoscopic abdominal hysterectomies than after open abdominal hysterectomies. Complication rates were about the same for vaginal and laparoscopic vaginal surgeries. (These rates do not apply to radical hysterectomy done to treat cancer.)
- About 11% of women had at least one major complication after the laparoscopic abdominal surgery, compared with about 6% of those who had an open abdominal surgery.
- Although most major complications were equally rare after both types of surgery, more women had heavy blood loss requiring a transfusion after abdominal laparoscopic hysterectomy (4.6%) than after open abdominal hysterectomy (2.4%).
Minor medical complications after hysterectomy
Rates of minor complications after vaginal hysterectomy and abdominal hysterectomy (rounded to nearest 0.5%):8
Minor medical complications after hysterectomy Type of complication Vaginal hysterectomy (without laparoscopy) Abdominal hysterectomy (without laparoscopy) Heavy blood loss not requiring transfusion
1%
1%
Fever
7%
3%
Infection
14%
16%
Collection of blood (hematoma) at the surgery site not needing surgical drainage
6%
6%
At least one minor complication
28%
27%
In the study described above, there was no significant difference in minor complication rates, whether the hysterectomy was laparoscopic, vaginal, or abdominal. (These rates do not apply to radical hysterectomy done to treat cancer.)
Infection risk is lowest when your doctor gives you antibiotic medicine at the time of surgery.11
Other ongoing complications of hysterectomy include:
- Difficulty urinating. This is more common after removal of lymph nodes, ovaries, and structures that support the uterus (radical hysterectomy).
- Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. The weakness can cause bladder or bowel problems, such as cystocele, rectocele, or urinary incontinence (which is most common in women over age 60).12Kegel exercises may help strengthen the pelvic muscles and ligaments. However, some women need other treatments, including additional surgery.
- Continued heavy bleeding. Some vaginal bleeding within 4 to 6 weeks following a hysterectomy is expected. However, call your health professional if bleeding continues to be heavy.
- Early menopause caused by a slow, yet early decline of the ovaries (premature ovarian failure).3
- The formation of scar tissue (adhesions) in the pelvic area.
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| Author: | Kathe Gallagher, MSW | Last Updated: August 25, 2006 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology | |
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