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What are the possible risks that can occur when undergoing gynecological pelvic surgery?

Most women who undergo pelvic surgery have good outcomes. However, sometimes despite the best of care, complications do occur. It has been estimated that operative complications during or after surgery is occurs in up to 5% of women undergoing a gynecological surgery. Fortunately, most of these complications are minor and serious ones uncommon. So what are these risks? We can classify them to those which are serious/life threatening and those which are not.

 

Frequent risks

  1. Wound infection and/or skin bruising
  2. Delayed wound healing
  3. Keloid/scar
  4. Wound pain
  5. Urinary tract infection
  6. Pelvic adhesions

 

Serious risks (uncommon)

  1. Excessive bleeding requiring blood transfusion (1-2.5%)
  2. Damage to the bladder/urinary tract (1-2%)
  3. Damage to the bowel (<1%)
  4. Deep vein thrombosis or pulmonary embolism
  5. Pelvic hematoma or abscess
  6. Incisional hernia

 

These are some of the general risks that any woman may encounter during a major gynaecological operation such as a hysterectomy, myomectomy, ovarian cystectomy or oophorectomy. However, the serious risks mentioned are uncommon.

 

There are certain patient risk factors that will increase the complication rate such as age, high BMI, multiple previous surgeries or history of previous complications.

 

There are also specific types of risks for certain gynaecological conditions and surgery. In pelvic cancer surgery, other than removal of the diseased uterus or ovary, lymphadenectomy is often performed which increases the risk of lymphoedema (swelling of the legs) in 15 to 20% of women and lymphocyst formation (up to 10%). Nerve injuries may occur as well and patients may feel some numbness or tingling sensation in the skin around the pelvis. In laparoscopic surgery, specific risks include unintended laparotomy, abdominal wall vascular injury (0.5%), hernia at the site of entry (<1%), subcutaneous emphysema and shoulder tip pain.

 

Even though complications do occur, the risks are generally very low due to modern advances in surgical techniques and equipment. When you are going for a planned surgery, do speak with your doctor and understand the risks before signing the consent.

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