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Hysterectomy Complications: What You Need To Know

Hysterectomy is, for women, the second most often performed surgical procedure. Hysterectomy refers the removal of the uterus although in about 40% of operations the ovaries and fallopian tubes are also removed. In the United States, about 33% of women will have had a hysterectomy by the age of 60.

There are several reasons for performing a hysterectomy. Uterine fibroids are usually benign tumors which can be quite small or as large as a baseball. Symptoms of fibroids include painful menses with heavy blood flow. Unless the symptoms interfere with a woman's life, a hysterectomy is usually not necessary.

Extremely heavy menstrual bleeding is another reason for having a hysterectomy. Abnormal blood loss during menstruation can lead to anemia and related health issues.

Cervical dysplasia is considered to be a pre-cancerous condition. It is usually discovered during a routine pap smear. Hysterectomy in this case is performed as a preventative procedure to avoid cervical cancer at a later date.

Endometriosis is a condition in which the tissue which lines the uterus during the monthly menses migrates to other areas of the abdomen like the ovaries and the wall of the pelvis. The condition is extremely painful since the tissue reacts to the hormones during the menses just as it would inside the uterus. The condition can cause infertility.

Uterine prolapse is a condition that usually occurs after multiple pregnancies. The muscles which hold the uterus in place are stretched and weakened by the pregnancies and the uterus collapses. The condition can also occur following a multiple birth or the birth of an unusually large infant.

Only about 10% of the 600,000 hysterectomies performed in the US each year are related to cancer. Since less invasive medical and surgical procedures are available to treat other conditions, some doctors have questioned the need to perform so many hysterectomies.

Since hysterectomy is major surgery, the is always a risk of adverse reaction to anesthetic, the risk of hemorrhage, blood clots and infection. These complications are common to all surgeries. Women who are undergoing a hysterectomy typically receive oral antibiotics prior to the surgery to help ward off infection.

In most cases, the doctor will try to have the patient walking within 24 hours of surgery. This helps to prevent blood clots from forming in the legs and lungs. If hemorrhage should occur either during or after surgery, a transfusion may be necessary. If the hemorrhage is severe, the patient may need to be returned to the operating room for additional surgery.

If the ovaries are removed during the surgery, the patient will immediately undergo surgical menopause. Symptoms like hot flashes, night sweats, depression hair loss, weight gain, irritability and diminished libido are not uncommon. Unless it is contraindicated by a condition such as cancer, hormone replacement therapy may ease these symptoms.

If the ovaries are not removed during surgery, the patient will still undergo menopause, just at a slower rate. Following a hysterectomy, blood flow to the ovaries is reduced and they will cease normal function within about three to six months of surgery.

IN cases where patients do not wish standard hormone replacement therapy or have a reaction to synthetic hormones, there are herbal supplements which can be used to ease the symptoms of menopause. Before taking these herbal supplements, a patient should consult her doctor. As with synthetic hormone replacement therapy, these supplements may not be appropriate for women with certain types of cancer. Some cancers are related to estrogen and patients with these cancers should not take estrogen replacement supplements.

Hysterectomy has the same risks and basic complications of any major surgery. The additional complication of early menopause can make patients more prone to heart attacks, certain cancers and premature signs of aging. It is wise to explore other therapies and treatments for conditions other than cancer before undergoing a hysterectomy. This surgery should only be used for treatment of less life threatening conditions as a last resort.



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