Your Risks with Major Surgery
Hysterectomy is performed in a hospital setting, and generally requires approximately two hours in the operating room. Patients are given general or spinal anesthesia plus sedation so that they feel no pain. Heart rate, blood pressure, blood loss, and respiration are closely observed throughout the procedure. After surgery, patients are transferred to the recovery room where they can be monitored while waking up. Most patients will then be transferred to a hospital room, where they will spend one to two nights.
A number of complications can occur as a result of hysterectomy. Fortunately, most can be easily managed and do not cause long-term problems.
Hemorrhage — Excessive bleeding occurs in a small number of cases and may require a return to the operating room to identify and stop the bleeding.
Infection — Low-grade fever is common after hysterectomy, is not always caused by infection, and usually resolves without treatment. However, a high or persistent fever may signal an infection. Serious infection occurs in less than ten percent of women, and can usually be treated with intravenous antibiotics. Much less commonly, patients require another surgical procedure.
Constipation — Constipation occurs in most women following hysterectomy, and can usually be controlled with a regimen of stool softeners, dietary fiber, and laxatives.
Urinary retention — Urinary retention, or the inability to pass urine, can occur after abdominal hysterectomy. It is more common in women who have vaginal hysterectomy. Urine can be drained using a catheter until retention resolves, usually within 24 to 48 hours.
Blood clots — Pelvic surgery increases the risk of developing blood clots in the large veins of the leg or lung. The risk is increased for approximately six weeks after surgery. Medications may be given to some women to prevent blood clots. In addition, women taking oral contraceptives or hormone replacement should ideally discontinue them prior to surgery since they can further increase the risk of blood clots. Women who are sexually active and premenopausal should use alternative methods of birth control to prevent pregnancy before surgery.
Damage to adjacent organs — The urinary bladder, ureters (small tubes leading from the kidneys to the bladder), and large and small intestines are located in the lower abdomen and pelvis and can be injured during hysterectomy. Injury occurs in less than one percent of all women undergoing hysterectomy, and can usually be detected and corrected at the time of surgery. If detected after surgery, another operation may be needed.
Early menopause — Women who have undergone hysterectomy may experience menopause earlier than the average age of menopause (age 51). This may be due to an interruption in blood flow to the ovaries as a result of removing the uterus.