Hysterectomy
Risks of Hysterectomy
Hysterectomy poses some risks of major and minor complications. But 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).Reference 4, Reference 5 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%):Reference 3
| 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 (Reference pulmonary embolism Opens New Window) |
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.)Reference 3
Minor medical complications after hysterectomy
Rates of minor complications after vaginal hysterectomy and abdominal hysterectomy (rounded to nearest 0.5%):Reference 3
| 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 Reference antibiotic Opens New Window medicine at the time of surgery.Reference 6
Other ongoing complications of hysterectomy include:
- Difficulty urinating. This is more common after removal of Reference lymph nodes Opens New Window, ovaries, and structures that support the uterus (radical hysterectomy).
- Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. Reference Kegel exercises may help strengthen the pelvic muscles and ligaments. But some women need other treatments, including additional surgery.
- Continued Reference heavy bleeding Opens New Window. Some vaginal bleeding within 4 to 6 weeks following a hysterectomy is expected. But call your doctor if bleeding continues to be heavy.
- Some women may experience early Reference menopause Opens New Window.
- The formation of scar tissue (Reference adhesions Opens New Window) in the pelvic area.
| By: | Reference Healthwise Staff | Last Revised: Reference January 9, 2012 |
| Medical Review: | Reference Sarah Marshall, MD - Family Medicine
Reference Kirtly Jones, MD - Obstetrics and Gynecology |
|
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