Womens Health

 Are there dangerous symptoms that I need to watch for after surgery for hysterectomy? 

Most of the severe complications of surgery will show themselves within the first 2-3 weeks after the operation although sometimes these can manifest even later.

  • re operation - complications requiring repeat surgery to repair them (2%)
  • Vascular thrombosis or hemorrhage causing a stroke or heart attack (<1%)
  • Intraoperative or delayed post operative intraperitoneal bleeding requiring blood transfusion (5%)
  • a pus type of drainage or extensive redness of the incision can indicate wound abscess (3-5%)
  • watery, urine-like vaginal discharge may indicate ureteral or bladder injury or fistula (1-2%)
  • leg calf or thigh pain and swelling may indicate a blood clot (<3%)
  • sharp chest pains and breathing difficulty can indicate a blood clot that has broken off to the lung (<1%) or a pneumonia (<1%) or even a heart condition (<1%).
  • pelvic pain with bowel and bladder symptoms may indicate pelvic infection or abscess or a delayed postoperative bleed internally.
  • prolonged bowel laziness (illeus) with bloating and absent bowel movements may also indicate pelvic infection or abscess, a delayed postoperative bleed internally, or ureter or bladder injury.

There can also be major complications that show themselves later than 3 or 4 weeks after surgery.

  • ovarian abscess (4-60 weeks) (4)
  • late pulmonary embolus (up to 6 months after surgery)
  • small bowel obstruction (6 mos to 10 years) (5)
  • vaginal vault prolapse (within two years if related to surgery) (<1%)(6)
  • persistent pain with intercourse due to adhesions or abnormal scar formation at the end of the vagina

What are some of the rare or unusual complications that are possible after hysterectomy?

Many of the complications mentioned above are uncommon. There are some even rarer problems that may occur.

  • drug induced blood dyscrasias (anemia, low platelets) (7)
  • massive hemorrhage resulting in death
  • bowel injury requiring colostomy
  • bladder atony and inability to void urine
  • liver failure due to anesthetic complications
  • chronic incisional pain or drainage due to suture granulomas, endometriosis or foreign body reaction
  • abdominal compartment syndrome (decreased blood flow to intraabdominal organs)(8)
  • kidney shutdown due to renal artery spasm (9)
  • abdominal or vaginal herniation of the bowels (evisceration) through the incisions (10)
  • and many other rare and uncommon events

When can I resume different normal activities after surgery to remove the uterus?

Doctors will vary significantly in their recommendations for postoperative activity resumption and there is a noticeable lack of scientific studies performed to assess what the recommendations should be.

There are some general principles that should be followed and practical recommendations that follow from them.

Table of Contents
1. Post-Hysterectomy
2. Symptoms after surgery
3. Severe complications
4. Tips for recovery
5. Back to work
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