A hysterectomy as a surgical means for removing the uterus is often resorted to when the female reproductive system develops complications. A hysterectomy would be the preferred option for combating the symptoms associated with cancer, endometriosis, fibroids, and painful and excessively heavy bleeding during menstruation. Generally, most women emerge successfully from surgery without experiencing complications, but sometimes, major and minor complications can impact the patient’s health.
Whether you opt for abdominal surgery, vaginal surgery, or laparoscopic surgery--the three major hysterectomy techniques--an element of risk is inherent in all procedures. The success or failure of surgery rests wholly in the hands of the surgeon and the degree of skill and experience that he brings to the operating table.
Major risk factors of having a hysterectomy done
The majority of women going under the knife rarely suffer any collateral damage or health complication. Nevertheless, a clearer understanding of the risk factors is useful in making up one’s mind before opting for a hysterectomy. Risk factors can be divided into major symptoms that require emergency medical care and minor issues that can be tackled on an ongoing basis.
- ·Wounds reopening (Dehiscence): Wounds refusing to heal can be a source of great distress to the post-operative patient. The stapling clips may come loose, thereby reopening the wound which begins to leak.
- ·Vaginal bleeding: There is always a small risk of heavy bleeding (or haemorrhage) post all major operations and surgical procedures. Sometimes, internal stitches crack and wounds open up causing massive bleeding through the vaginal cuff. Bleeding is observed after 4 to 6 weeks a hysterectomy is performed and may include some blood discharge through the vagina but in the case of constant and heavy blood flow, the doctor should immediately be contacted. Excessive loss of blood may call for an emergency blood transfusion.
- · Damage to Bladder or Bowel: Damage to abdominal organs, like bladder or bowel are observed in very rare cases and may lead to various problems like:
- Incontinence or lack of control
- A frequent urge to urinate
It is, however, possible to repair the damage during the hysterectomy. One may need a temporary catheter (a flexible and thin tube inserted into the body cavity through a narrow opening) to remove the fluids (urine) or a colostomy to collect the faeces.
- ·Bladder and ureter injury: Because of the proximity of the bladder and ureter to the uterus, a small surgical error may damage the organs seriously enough to trigger hematuria (blood in urine).
- ·Bowel injury and peritonitis: It is possible for surgical procedures to inadvertently create bowel perforations that develop into post-operative complications including peritonitis.
- ·Blood clots in legs and lungs: One of the major risks of gynecological surgery is the prevalence of clots that could obstruct vascular supply to the legs and lungs. Patients are put on blood thinners to avert the risk post-surgery. The accumulation of blood in the region where the surgery was made is collectively referred to as 'Hematoma' and requires surgical draining for the removal of the clot.
- ·Problems with anesthesia: Anesthesia can create complications in some patients such as air embolism (air bubble trapped in a vein or an artery), lung inflammation due to reverse aspiration of stomach contents, and cardiac problems.
- ·Ovary Damage or Failure: Even if one or both the ovaries of the female are left without removal post-hysterectomy, there is a strong possibility that they may completely damage after crossing a period of five years. This may happen because the womb is responsible for supplying the ovaries with some amount of blood supply and if this source is removed, then the supply of oxygen would be hindered and the ovaries may not be able to receive the required amount of oxygen.
- ·Early Menopause : Once the ovaries are removed, then it's obvious that the female would definitely experience the menopausal symptoms soon after the surgical operation, such as:
- Hot Flashes and Sweating
- Dryness in the vaginal area
- Disturbed sleep
These all symptoms arise because the menopause is triggered and the female becomes incapable of producing the eggs from the ovaries, or in other words, stops ovulating. High risks factors are encountered in females below the age of 40 years, since, the early onset of menopause may lead to increased chances of developing osteoporosis (a condition when the bones become brittle or fragile) because of decreased oestrogen levels in the body. Hence, it is highly recommended that such females should take additional care and proper medication to avoid these circumstances.
Minor risk factors associated with a hysterectomy
These are risk factors that are part and parcel of the post-surgical recovery phase, and exercise, adequate rest, and medication are more than enough to take care of symptoms and for the patient to resume a normal life.
- ·Infection that can be controlled with a course of antibiotics.There is always a possibility of acquiring an infection after the operation. This may be a wound infection or a UTI (Urinary Tract Infection). These doesn't cause severe damage and can be easily treated with antibiotics.
- ·Fever and pain, which can be tackled by medication such as Tylenol and ibuprofen.
- · The vagina, rectum, and bladder anatomically shift after surgery due to the void created by the removed uterus and the slackness of supporting musculature. This heals as soon as the pelvic muscles regain their firmness.
- · An overactive bladder may make you visit the toilet more often, even when there is less urine to expel. This happens due to a weakening of the pelvic muscles supporting the bladder. A marked discomfort in urinating is more commonplace when ovaries and lymph nodes are removed along with the uterus.
- · Urethral soreness may continue for a couple of days because of the use of a urinary catheter to drain urine from the bladder during the operation.
- · Bleeding continues in patches for a while following surgery, but this may not require surgical intervention once the internal wounds are given time to heal.
- ·The appearance of pelvic adhesions or scar tissues.
- · One may experience difficulty during urination. This is common when the ovaries, lymph nodes or the other supporting structures of the uterus have been removed through the radical hysterectomy.