Hysterectomy Complications

Hysterectomy is the surgical removal of the uterus or womb. But it is not as simple as it sounds in this definition. According to the research done by the HERS foundation and Hysterectomy Association, it has far-reaching consequences, not just on a woman's body but also on her psychological aspect as a whole. The most telling statistic in their research tells us that after the surgery, 58% of women are unable to return to their previous work activities and about 43% are unable to return to work at all. Now, that is some cause for worry! The complications start even before the actual surgery.

Complications of Hysterectomy

A recently published report by Obstetrics and Gynecology points out a bitter fact that the symptoms for nine out of every 12 hysterectomies did not meet the guidelines set by the American College of Obstetricians and Gynecologists for requiring the procedure. Hysterectomy is sometimes wrongly recommended or even many women unnecessarily undergo the procedure when they can get relief from alternative procedures like uterine artery embolization, myomectomy, endometrial ablation laser surgery or loop electrocautery, for cases of abnormal pap smear. This is called an 'elective surgery', since it is not performed as an emergency requirement. It is, primarily, performed in the cases of uterine cancer, uterine fibroids, persistent vaginal bleeding (menorrhagia), endometriosis, chronic pelvic pain during menstruation, prolapsed uterus, etc. You have to ensure the necessity for the surgery from a specialist doctor.

The most common hysterectomy is performed through a cut in the lower abdomen. On the other hand, the less common way is to remove the uterus only through a cut in the top of the vagina, after which the top of vagina is stitched. During the surgery, general anesthetic is used which can lead to allergic reactions and some minor nerve damage. Excessive blood loss can happen, thus, requiring the need of blood transfusion. Also, there is a risk of urinary tract infection, vaginal or chest infection. The most severe risk is bladder injury, which can happen during the incision of abdomen. It is called 'blind' incision as the surgeon cannot see the underlying organs. Even if the injury is prevented, the risk of bladder incontinence or frequent need of urination exists after most hysterectomies. Also, the Hysterectomy Association clarifies that if a woman undergoes the surgery but leaves her ovaries in place, she has a 50% chance of suffering ovarian failure within 5 years of surgery.

Post Surgery Complications

No matter how successfully the surgery is, a woman has to deal with some complications. How a woman reacts to the physical changes have a major bearing on her psychological acceptance of the change. You have to accept the fact that you will no longer be able to give birth, and there's a 50% chance of menopause within five years of the surgery, irrespective of your age. If the surgery involved is oophorectomy (surgery to remove the ovaries), then menopause will start immediately after the surgery. Even a normal menopause causes several mood changes leading to depression, anxiety and irritability. So, a sudden occurrence of menopause can be emotionally disturbing. The other complications are given below.

• For about six weeks from the surgery, the risk of blood clots is high in the large veins of the leg and lungs. Oral contraceptives and hormonal replacement medications further increase this risk. Many women experience burst of bleeding within two to three weeks of the surgery.
• Apart from the urinary incontinence as described above, urinary retention (inability to pass urine) is seen mostly with the women who have undergone vaginal hysterectomy. Even, constipation is a frequent occurrence, given the direct effect on the bowel movements.
• If the ovaries are removed, then vast hormonal changes take place with reduced hormone levels, leading to loss of bone density, weakness of pelvic floor and vaginal muscles, and increased risk of a heart attack.
• Sexual life is directly affected with diminished or absent sexual desire for foreplay and intercourse or loss of orgasm. Also, sensation in the clitoris and labia is diminished.
• Reduction in energy levels is manifested with profound fatigue, loss of stamina and eventual weight gain coupled with back pain, aching muscles, stiffness, numbness and tingling in hands, arms and legs.
• The HERS foundation research denotes that the major after-effect is the personality change in women leading to difficulty in socializing, short term memory loss, with creeping bouts of nervousness and headache.

These major complications are very much dependent upon the type of surgery performed (open surgery requires larger incisions and a laparoscopic surgery is done with smaller incisions) and whether it involves complete or partial hysterectomy. It is entirely up to the woman how she deals with the side effects, as they can present widespread consequences for her on the social and personal front.