While a hysterectomy is a very common procedure, it is major surgery, with a significant recovery time. Some risks of hysterectomy are minor, but there are several major risks and long term consequences to consider.
Most women do not have complications, and are very happy post surgery as hysterectomy is often a last resort to resolve several painful conditions (endometriosis, adenomyosis, large fibroids, painful, heavy periods). Sometimes a hysterectomy is recommended to treat or prevent cancer. Most women feel relief and an improved sense of well being after the recovery period is over.
Studies show that vaginal hysterectomies have fewer complications and a shorter recovery time than an abdominal hysterectomy or laporascopic hysterectomies.
Risk of hysterectomy is individual, however, and will depend on your general health, and any chronic or acute conditions.
Complications after a hysterectomy include:
- Heavy blood loss requiring a transfusion
- Bladder or bowel injury
- Blood clot to the lung
Long term complications can include:
- Decrease in sexual desire and function (especially if both ovaries have been removed). Some also believe that removal of the cervix means less intense orgasms and/or the inability to reach orgasm post surgery. The scientific studies do not support that conclusion.
- Feelings of loss and depression, especially if the woman is younger and may not be ready to lose her ability to have children.
- Increased risk of osteoporosis. (If both ovaries have been removed. HRT can ameliorate this risk)
- Pelvic weakness and vaginal prolapse. Some surgeons believe that keeping the cervix in place reduces the risk of vaginal prolapse, but the scientific studies do not support this conclusion.
- Vaginal dryness (if both ovaries have been removed. HRT can ameliorate this risk.)
- Early menopause even if ovaries were retained. Sometimes women go into menopause a few years earlier than otherwise expected after a hysterectomy. The reason for this is unknown.
- Difficulty urinating. This is very rare and is usually only associated with a radical hysterectomy.
If the ovaries have been removed, the woman will go into instant surgical menopause, which is much more suddeb and severe than natural, gradual menopause. Menopause has its own set of symptoms and complications so the decision of whether to remove the ovaries needs to be weighed carefully.
The symptoms of surgical menopause may be relieved by taking Hormone Replacement Therapy (HRT). You should discuss with your surgeon very carefully whether you should have your ovaries removed, and whether HRT is appropriate for you. If there is cancer, suspected cancer or a genetically high risk of ovarian cancer, they should be removed. In all other cases, the ovaries are usually be kept in place.