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Hysterectomy (cont.)

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).4, 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%):3

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.)3

Minor medical complications after hysterectomy

Rates of minor complications after vaginal hysterectomy and abdominal hysterectomy (rounded to nearest 0.5%):3

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.6

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. Kegel exercises may help strengthen the pelvic muscles and ligaments. But some women need other treatments, including additional surgery.
  • Continued heavy bleeding. 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 menopause.
  • The formation of scar tissue (adhesions) in the pelvic area.
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