Approximately 20 million American women have undergone a hysterectomy, or surgical removal of the uterus, as of 2010, notes the Centers for Disease Control and Prevention, adding that close to 600,000 women undergo the procedure each year in the United States. The choice of a vaginal, laparoscopic or abdominal operation is based on the reasons for performing the surgery and individual risks, as are decisions regarding removal of the ovaries, fallopian tubes and cervix. While most hysterectomies are uncomplicated, problems sometimes occur following surgery.
Urinary Incontinence
Having a hysterectomy increases the risk of developing loss of control over urination by 30 percent, according to a study of 1,626 suburban women between the ages of 35 to 70. Called urge incontinence, the symptoms include having a sudden strong urge to urinate whether or not the bladder is full, urine leakage and the inability to reach the bathroom in time. Researchers noted that urge incontinence was not found more frequently in elderly women. The study, conducted in the Netherlands and published in the February 2002 issue of the "British Journal of Obstetrics and Gynecology," did not find a link between hysterectomy and milder stress incontinence, which is characterized by the escape of small amounts of urine in response to coughing, sneezing, laughing or other jarring physical activities.
Infection
In a 2009 study, Chinese researchers reported that of 3,722 Bejing women who underwent hysterectomies for non-cancerous conditions, 162 required hospital stays longer than nine days for treatment of complications. Postoperative fever was the reason in 114 cases, 82 of which were confirmed to be related to surgery. Twenty-four women who had concurrent health conditions and who underwent abdominal hysterectomies had infected incisions. Other complications included hematoma, bleeding and organ injury.
Early Menopause
When both ovaries are removed during a hysterectomy in premenopausal women, estrogen loss results in menopause without the addition of hormone replacement therapy. Early menopause has also been found to be a long-term complication of hysterectomies even when the ovaries were not removed. New Zealand researchers who conducted a comparison of 516 premenopausal women subjects, 259 of whom had hysterectomies, found that menopause occurred four years earlier in women who underwent hysterectomies, even when both ovaries were retained and the analysis was controlled for smoking, obesity and preoperative baseline hormone levels. The findings were published in the July 2005 "British Journal of Obstetrics and Gynecology." Similarly, a Korean study published in the February 2002 "Yonsei Medical Journal" followed 94 women who had abdominal hysterectomies without ovary removal. The researchers determined that the younger the women were at the time of surgery, the earlier they reached menopause.
References
- CDC: Hysterectomy
- "British Journal of Obstetrics and Gynecology"; The Contribution of Hysterectomy to the Occurrence of Urge and Stress Urinary Incontinence Symptoms; van der Vaart, C.H., et. al.; February 2002
- "Zhonghua Yi Xue Za Zhi"; Complications of Hysterectomy: Analysis of 162 Cases; Zhao J., et al.; Nov. 10, 2009
- "British Journal of Obstetrics and Gynecology"; The Association of Hysterectomy and Menopause: a Prospective Cohort Study; Farquhar, C.M., et al.; July 2005
- "Yonsei Medical Journal"; Effect of Hysterectomy on Conserved Ovarian Function; Ahn, E.H., et al.; February 2002
