New Study Adds to Hysterectomy Surgery Risks

A recent study published in the journal Menopause and reported in ScienceDaily adds to the growing list of risks associated with hysterectomy, including heart failure and heart disease. Mayo Clinic researchers conducted the study on more than 2,000 women under age 35 who underwent egg-preserving hysterectomy. The women were followed over a nearly 22-year period, and results were compared to women who had not undergone the surgery.

Researchers reported that study patients who had a hysterectomy were:

  •  4.6 times more likely to suffer congestive heart failure
  •  2.5 times more likely to get heart disease
  •  Also at increased risk of high blood pressure, high cholesterol, obesity and irregular heartbeats

“This is the best data to date that shows women undergoing hysterectomy have a risk of long-term disease – even when both ovaries are conserved,” said study lead author and Mayo Clinic OB-GYN Shannon Laughlin-Tommaso, M.D. “While women are increasingly aware that removing their ovaries poses health risks, this study suggests hysterectomy alone has risks, especially for women who undergo hysterectomy prior to age 35.”

RMG interventional radiologist Juan Rodriguez, M.D., said that while further research will be needed to prove a direct cause and effect, women with symptomatic fibroids thinking about total abdominal hysterectomy should talk to their doctors about less invasive alternatives, including uterine fibroid embolization (UFE).

Additional significant risks associated with hysterectomy include:

  •  A 17-23% complication rate1,2
  •  A 60% increased risk of incontinence by age 603
  •  Increased risk of lung cancer4
  •  Menopause approximately two years sooner5

Additional complications associated with hysterectomy include:

  •  Infection
  •  Fever
  •  Hemorrhage
  •  Bowel and bladder damage
  •  Death (< 1% of cases)
  • Deteriorated sexual function (10-20% of women) after hysterectomy6

Recommended alternative

UFE is recommended by the American College of Obstetrics and Gynecology as a non-surgical alternative to hysterectomy. It results in less blood loss, shorter hospital stays, a lower complication rate and a faster return to work.

Further research shows that 90 percent of women who undergo UFE have demonstrated a high level of satisfaction and a significant improvement in quality of life – even over the long term. The odds of fibroids returning after UFE are also extremely low, compared with the up to 51% of uterus-preserving myomectomy patients who require further surgery.

References

  1. Makinen J, Johansson J, Tomas C, et al. Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod. 2001;16(7):1473–8. [PubMed]
  2. Harkki-Siren P, Kurki T. A nationwide analysis of laparoscopic complications. Am J Obstet Gynecol. 1997;89(1):108–12. [PubMed]
  3. Brown JS, Sawaya G, Thom DH, Grady D. Hysterectomy and urinary incontinence: a systematic review. The Lancet. 12 August 2000
  4. Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses’ health study. Am J Obstet Gynecol. 2009 May;113(5):1027-37. doi: 10.1097/AOG.0b013e3181a11c64
  5. Trabuco EC, Moorman PG, Algeciras-Schimnich A, et al. Association of Ovary-Sparing Hysterectomy With Ovarian Reserve. Am J Obstet Gynecol. 2016; 28(5):819–827
  6. Lonnée-Hoffmann R, Pinas I, Effects of Hysterectomy on Sexual Function. Curr Sex Health Rep. 2014; 6(4): 244–251. Published online 2014 Sep 14. doi: 10.1007/s11930-014-0029-3
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