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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Scheduled For Vaginal Hysterectomy. What Are The Chances Of Doctor Inadvertently Nicking Another Organ?

I am scheduled for a vaginal hysterectomy as my cervix is protruding. I suspect this is a better choice that the regular hysterectomy. What are the chances of the doctor inadvertently nicking another organ, and how involved is the recovery ? I live in a house with 5 stairs at the entrance. Will I have to have a ramp made so I can enter my own home ?
Thu, 7 Nov 2013
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OBGYN 's  Response
Hello
Thanks for your query.
For a prolapse, that is, when the cervix is already outside the normal position, a vaginal hysterectomy is better than a regular one, as it is easier.
Ureteral injuries are common, owing to the size and location of the ureter, and generally are the result of excessive electrocautery and lasering adjacent to the ureter during surgery.The incidence is reported to be 0.5% for hysterectomy performed for benign disease and up to 1.6% for laparoscopically-assisted hysterectomy.

The risk of bowel injury varies depending on the type and method of the hysterectomy. The incidence of bowel injuries is 0.4%, with laparoscopically-assisted abdominal hysterectomy carrying the largest risk.

Bladder injuries occur in up to 2% of hysterectomy cases. In vaginal hysterectomy, the bladder can be perforated during entry into the anterior cul-de-sac.

The most serious postoperative complication of hysterectomy is hemorrhage, which occurs in 1% to 3% of patients.

Infection is a common postoperative complication associated with hysterectomy. Four percent to 10% of patients undergoing vaginal hysterectomy and 6% to 25% of those having abdominal hysterectomy develop an infection postsurgery.
While the aforementioned complications are more common, the following complications, although rare, also can occur: atelectasis, fallopian tube prolapse, thromboembolic disease, myocardial infarction, stroke, and renal failure.

Early menopause is the result of hormonal changes secondary to hysterectomy.
You would be discharged within a week, and can return to normal activities within 2 months, stairs would be okay after 2 months I guess.
take care.
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Scheduled For Vaginal Hysterectomy. What Are The Chances Of Doctor Inadvertently Nicking Another Organ?

Hello Thanks for your query. For a prolapse, that is, when the cervix is already outside the normal position, a vaginal hysterectomy is better than a regular one, as it is easier. Ureteral injuries are common, owing to the size and location of the ureter, and generally are the result of excessive electrocautery and lasering adjacent to the ureter during surgery.The incidence is reported to be 0.5% for hysterectomy performed for benign disease and up to 1.6% for laparoscopically-assisted hysterectomy. The risk of bowel injury varies depending on the type and method of the hysterectomy. The incidence of bowel injuries is 0.4%, with laparoscopically-assisted abdominal hysterectomy carrying the largest risk. Bladder injuries occur in up to 2% of hysterectomy cases. In vaginal hysterectomy, the bladder can be perforated during entry into the anterior cul-de-sac. The most serious postoperative complication of hysterectomy is hemorrhage, which occurs in 1% to 3% of patients. Infection is a common postoperative complication associated with hysterectomy. Four percent to 10% of patients undergoing vaginal hysterectomy and 6% to 25% of those having abdominal hysterectomy develop an infection postsurgery. While the aforementioned complications are more common, the following complications, although rare, also can occur: atelectasis, fallopian tube prolapse, thromboembolic disease, myocardial infarction, stroke, and renal failure. Early menopause is the result of hormonal changes secondary to hysterectomy. You would be discharged within a week, and can return to normal activities within 2 months, stairs would be okay after 2 months I guess. take care.