Risk of removing uterus: Hysterectomy Risks

Verified by Dr. Vaishali Sakpal Rane (MBBS, DGO Obstetrics and Gynaecology, DNB Obstetrics and Gynaecology

The surgery in which the uterus is removed is called Hysterectomy. It is a common surgery and is relatively safe.

Uterus is commonly known as the womb where the baby grows. The lining of the uterus is shed every month which is marked as periods. The ovaries produce estrogen and progesterone hormones and release the egg every month.

The fallopian tubes carry the egg from ovary to uterus. Also the process of fertilisation i.e. mating of sperm and egg happens in the fallopian tubes.

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There can be several indications for uterus removal. The common ones are :

• Heavy menstrual bleeding
• Large fibroids 
• Cancer of the uterus or ovary or fallopian tubes
• Prolapse of uterus ie uterus coming out through the vagina

Depending upon the route of removal, hysterectomy can be of following types:

• Vaginal Hysterectomy - Uterus is removed through vagina. This is usually performed for a prolapsed uterus.
• Abdominal hysterectomy - Uterus is removed through a cut made on the abdomen. It is done especially for cancers or large fibroids.
• Laparoscopic Hysterectomy - It has become very popular in recent times because of minimal scar, less blood loss and faster recovery.

Hysterectomy is a major surgery and like any other surgery this also involves some risks and complications.

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1) Immediate risk 

These can occur on the operation table during surgery.

a) Excessive bleeding - especially in large fibroids, cancer patients or due to injury to some blood vessel. The doctors usually are successful in controlling this type of bleeding but sometimes it may require blood transfusion.

b) Anaphylactic reaction - It is a kind of severe allergic reaction to any anaesthetic drug or gas. Though anaesthetists are well equipped to handle such emergencies it may cause you to land up in ICU.

c) Injury to the neighbouring organs - This is more likely if you have had a previous surgery like a caesarean delivery or appendicectomy. This is because the organs tend to stick to each other after one surgery as a byproduct of healing, separating the organs from each other can cause damage to these organs.

There can be injury to the urinary bladder as it lies just in front of the uterus, injury to the rectum which is a part of the large intestine that contains the faeces. The rectum lies behind the uterus and injury to ureters can cause injury to any nearby blood vessels. If these injuries occur and are identified immediately, an additional expert surgeon may have to be called upon and the surgery can extend.

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2) Immediate post surgery - These complications can occur after surgery is over and you are still in hospital:

a) Infection

b) Bleeding

c ) Bloating

d) Atelectasis — which is lungs getting collapsed due to prolonged lying down position

e) Difficulty in passing urine after the temporary urine pipe is removed.

3) Delayed - They occur after you get discharged from the hospital 

a) Infection at the scar

b )Non Healing of the scar

c) Bleeding from vagina due to infection of the vault

d) Involuntary urine leakage due to fistula formation

e )Involuntary faecal leakage due to fistula formation 

In rare cases a second surgery may be required if complications occur

4) Late - They can occur after few months or years of surgery

a) If ovaries are removed then you can experience early menopause. You may require to take Hormone replacement therapy

b) Vault prolapse  - with aging tissues lose their support and the vault may come down

It’s important to talk to a doctor and know the risks and clear all your doubts before hysterectomy. Consult to gytree experts for any women health related issues.