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Hysterectomy - 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).7, 8 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%):6

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.)

  • About 11% of women had at least one major complication after the laparoscopic abdominal surgery, compared with about 6% of those who had an open abdominal surgery.
  • Although most major complications were equally rare after both types of surgery, more women had heavy blood loss requiring a transfusion after abdominal laparoscopic hysterectomy (4.6%) than after open abdominal hysterectomy (2.4%).

Minor medical complications after hysterectomy

Rates of minor complications after vaginal hysterectomy and abdominal hysterectomy (rounded to nearest 0.5%):6

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.9

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. However, 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.

WebMD Medical Reference from Healthwise

Last Updated: August 12, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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Vivelle-Dot is available by prescription only. Please ask your doctor if Vivelle-Dot is right for you.

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching, and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman’s ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

Important Safety Information

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT VIVELLE-DOT (AN ESTROGEN HORMONE)?

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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