Possible Hysterectomy Complications and Side Effects

Hysterectomies are the most common gynecologic procedures performed in the United States and may be performed for a number of reasons, ranging from fibroids to chronic pelvic pain to gynecologic cancer.

Still, many women who are advised to have a hysterectomy are naturally worried about the potential complications and side effects of the surgery, and how their bodies will respond after the removal of their uterus.

As with any surgery, there are certain complications that may arise with a hysterectomy, including:

• Infection and fever
• Bleeding
• Blood clots in the leg that can travel to the lung
• Anesthesia-related complications with the lungs or heart
• Nerve or tissue damage
• Bowel obstruction
• Formation of a fistula

A woman's medical history may make her more or less prone to developing these complications. For instance, obese women are more prone to infection and blood clots than normal-weight women.

The reason behind the surgery is another risk factor for developing complications. For example, fistula formation (albeit uncommon) is more likely to occur in women undergoing a hysterectomy for cancer versus women undergoing a hysterectomy for benign gynecological conditions like pelvic organ prolapse. 

The type of hysterectomy a woman is undergoing also affects her risk.

For example, in comparison to a vaginal or laparoscopic hysterectomy, with an abdominal hysterectomy, there is an increased risk for complications like infection, bleeding, blood clots, nerve damage, and bowel obstruction.

An abdominal hysterectomy also usually requires the longest hospital stay and recovery time.

With a laparoscopic hysterectomy, there is usually less pain and a lower risk of infection; however, there is an increased risk of injury to the bladder. 

There is also an increased risk of a rare, but very serious complication, called vaginal cuff dehiscence, with a laparoscopic hysterectomy.

There are several potential side effects that may occur after a hysterectomy.

The physical side effects of undergoing a hysterectomy include pain (usually for a few days) and vaginal bleeding and discharge (often for several weeks). Constipation is also common, and some women experience difficulties with urination or nausea or vomiting.

In addition, if the ovaries are removed, women who have not yet entered menopause will no longer menstruate (called surgical or induced menopause).

As a result, women may experience a range of menopausal symptoms, such as:

• Hot flashes
• Mood swings
• Vaginal dryness
• Night sweats

Keep in mind—women whose ovaries are not removed may still experience early menopause if blood flow to the ovaries is compromised.

Emotional side effects may also occur after a hysterectomy. While most women feel satisfied that their symptoms (e.g., pelvic pain or vaginal bleeding) are now gone,  some women in their childbearing years may feel anxious or depressed about the loss of fertility.

Sexual side effects are also a possibility. Fortunately, research shows that most women who were sexually active before surgery experience the same or better sexual functioning after surgery.

That said, sexual functioning after a hysterectomy is really a complicated topic. Every woman is different, and there are so many factors to consider, such as:

• Age
• The reason behind having the surgery (cancer versus a non-cancerous condition)
• The level of support provided by a woman's partner
• Mood problems that existed before the surgery

A hysterectomy is a common and generally safe surgical procedure. Complications though, and perhaps unforeseen emotional reactions, do occur. If you are experiencing any new and/or bothersome symptoms, please be sure to contact your doctor.