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Dr. Swaim: A fully informed surgical patient is the best surgical patient

Me & My OBGOctober 3, 2014Articles

No one wants to worry about complications from surgery, but risks do exist and they’re one reason that surgery should be performed only when indicated and when the patient is informed of both the benefits and the risks involved.

Know the risksHysterectomies are the most commonly performed gynecologic surgical procedures in the U.S. During this procedure, the uterus and cervix are removed. Different issues warrant the procedure, from chronic pelvic pain to pain or bleeding caused by fibroids. A hysterectomy is generally a safe procedure and while the list of possible complications seems long, luckily most are rare.

  • Bleeding: 1-3 out of 100 experience enough bleeding to require a blood transfusion.
  • Infection: Up to 10% of women may develop an infection after hysterectomy. These infections may range from simple urinary tract infections to more serious infections such as pneumonia. Antibiotics are given prior to surgery to decrease this risk.
  • Clots: Major surgery increases the risk of venous thromboembolism (blood clots in the legs or pelvis which may travel to the lungs). Your doctor will use preventative measures to diminish the chances of clots.
  • Organ damage: The bladder and ureters (tubes which bring urine from the kidneys to the bladder) are close to the uterus, so there exists about a 4% chance of damage of about to these organs. And because the bowel fills the pelvis, there is a small (about 1 of every 200 hysterectomies) risk of injury. Damage to the bladder, ureters, and bowel are most often repaired during the same operation without difficulty. Women who have had prior surgery, especially cesarean deliveries, are at an increased risk for surgical complications involving the bladder and bowel.
  • Numbness: Some women experience numbness of the skin of part of the legs or around the incision, and others may even notice weak muscles of the legs after surgery. This neuropathy almost always heals completely, but since nerves are slow to regenerate, it can take up to six months for full sensation to return.

While no patient wants to think about the possibility of complications, it is always better to be prepared for all the possibilities. When doctors suggest a surgical procedure like a hysterectomy as a treatment option, it should be when the benefits of surgery outweigh the risks of other treatment options. And with a highly trained, experienced physician, you surgical risks will be kept to absolute minimum.

Laurie S. Swaim, MD is director, Division of Gynecologic and Obstetric Specialists, Department of Obstetrics and Gynecology and Chief Gynecology Texas Childrens Pavilion for Women at the Baylor College of Medicine. 

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