Our Summary

This research looked at the occurrence of blood clots (venous thromboembolism or VTE) in patients who had a hysterectomy (surgery to remove the uterus) due to non-cancerous conditions. The study also examined if the method of surgery and the time taken for the surgery had any influence on the occurrence of these blood clots. The data was taken from a large database of surgical information from more than 500 hospitals in the US.

The study included data of over 122,000 hysterectomies performed between 2014 and 2019. The patients were divided into groups based on the weight of the uterus removed during the surgery.

The findings showed that blood clots were rare in patients who had a large uterus removed (0.64%). The size of the removed uterus did not significantly increase the risk of blood clots.

Interestingly, only 30% of the surgeries involving a larger uterus (over 500 g) were performed using minimally invasive methods. It was found that patients who had minimally invasive surgery (either laparoscopic or vaginal) had a lower risk of blood clots compared to those who had traditional open surgery (laparotomy).

Additionally, surgeries that took longer than 120 minutes had a higher risk of blood clots.

In simple terms, despite the size of the uterus, the risk of blood clots was low in patients who had a hysterectomy due to non-cancerous conditions. Minimally invasive methods and shorter surgery times are beneficial in lowering the risk of blood clots.

FAQs

  1. Does the size of the uterus removed during a hysterectomy influence the risk of blood clots?
  2. What impact does the method of surgery (minimally invasive vs traditional) have on the risk of blood clots in hysterectomy patients?
  3. Does the duration of the surgery influence the risk of blood clots in patients undergoing a hysterectomy?

Doctor’s Tip

A doctor might tell a patient about hysterectomy that it is important to discuss with your surgeon the possibility of using minimally invasive methods, such as laparoscopic or vaginal surgery, to lower the risk of blood clots. Additionally, it is important to understand that surgeries taking longer than 120 minutes may increase the risk of blood clots, so discussing the expected duration of the surgery with your surgeon is important. Overall, the risk of blood clots after hysterectomy for non-cancerous conditions is low, but taking these precautions can further reduce the risk.

Suitable For

Patients who are typically recommended hysterectomy include those with non-cancerous conditions such as fibroids, endometriosis, adenomyosis, abnormal uterine bleeding, pelvic organ prolapse, or chronic pelvic pain. Other reasons for recommending hysterectomy may include pre-cancerous conditions of the uterus, cervix, or ovaries. It is important for patients to discuss their options with their healthcare provider to determine if a hysterectomy is the best treatment option for their specific condition.

Timeline

Overall, the timeline of a patient before and after hysterectomy typically includes:

  • Initial consultation with a healthcare provider to discuss the need for hysterectomy and potential risks and benefits
  • Pre-operative assessments and tests to ensure the patient is medically fit for surgery
  • Admission to the hospital on the day of surgery
  • Anesthesia administration and the actual hysterectomy procedure
  • Post-operative recovery in the hospital, which may include pain management, monitoring for complications, and assistance with mobility
  • Discharge from the hospital and instructions for at-home recovery
  • Follow-up appointments with the healthcare provider to monitor healing and address any concerns or complications

After hysterectomy, patients may experience a range of physical and emotional changes, including relief from symptoms related to the underlying condition, menopausal symptoms (if the ovaries were also removed), and adjustments to changes in reproductive and sexual health. Support from healthcare providers, loved ones, and support groups can help patients navigate these changes and ensure a smooth recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy include:

  1. What are the potential risks and complications of having a hysterectomy?
  2. How will the size of my uterus and the method of surgery affect my risk of blood clots?
  3. Are there any specific factors in my medical history that may increase my risk of developing blood clots after surgery?
  4. What steps will be taken during and after the surgery to prevent blood clots?
  5. How long is the expected recovery time after a hysterectomy, and how soon can I return to normal activities?
  6. Will I need any follow-up appointments or tests to monitor for any complications, including blood clots?
  7. Are there any lifestyle changes or medications I should consider to reduce my risk of blood clots after a hysterectomy?
  8. What signs and symptoms of blood clots should I watch out for after surgery, and when should I seek medical attention?
  9. Will I need any specific post-operative care, such as wearing compression stockings or taking blood thinners, to prevent blood clots?
  10. How can I best prepare for a hysterectomy surgery to ensure a smooth recovery and minimize the risk of complications, including blood clots?

Reference

Authors: Pham NK, Jalloul RJ, Chen HY, Hui M, Leon MG. Journal: J Minim Invasive Gynecol. 2023 Nov;30(11):884-889. doi: 10.1016/j.jmig.2023.06.017. Epub 2023 Jul 6. PMID: 37422052