11 Complications of hysterectomy

The complications of hysterectomy are discussed, generally speaking their definition is poorly standardized and direct comparisons are extremely difficult. Furthermore, there is uncertainty as to what is meant by laparoscopic hysterectomy. The complications are discussed as post-operative fever, haemorrhage, injury to adjacent organs, other complications and life-threatening events. The incidence of post-operative infection and haemorrhage is least with the laparoscopic approach, but injury to surrounding organs is probably greater. In 1982, the Collaborative Review of Sterilization study data suggested an average woman of reproductive age with no pre-existing medical condition, no previous abdominal surgery, and who received prophylactic antibiotics, was best served by vaginal hysterectomy without colpororrhaphy rather than an abdominal procedure. This does not seem to have changed. The incidence of abdominal hysterectomy may be reduced by adding laparoscopy to vaginal hysterectomy to deal with adhesive disease, endometriosis or adnexal disease. Laparoscopic hysterectomy is feasible and safe but the indications for this approach have not yet been established.