Does Endometriosis Increase Hysterectomy Complications? Know Your Risk

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Endometriosis is a painful, chronic condition that can impact a person’s quality of life. Whether you’re considering a hysterectomy to treat endometriosis, remove fibroids or cysts, have permanent birth control, as gender-affirming surgery, or myriad other reasons, undergoing a hysterectomy when you have endometriosis may increase your risk of complications.

Luckily, working with a gynecological surgeon who’s aware of this risk and highly trained in both hysterectomy and endometriosis management can help mitigate your risk.

Does Endometriosis Increase Hysterectomy Complications? Know Your Risk

What is endometriosis?

Endometriosis is a disease in which the endometrium — tissue lining the uterine walls — grows outside the uterus. It may adhere to the fallopian tubes, ovaries, and/or pelvic wall.

The errant endometrial tissue responds to hormones in the same way uterine tissue does during the menstrual cycle, resulting in painful symptoms. Symptoms of endometriosis can include pelvic pain, inflammation, lesions, and scar tissue (adhesions). There is no known cure for endometriosis, although traditional treatments such as hormonal contraceptives and pain medication can help manage symptoms.

What are the risks associated with hysterectomies and endometriosis?

The field of women’s healthcare has long known that patients with endometriosis are at higher risk of complications after a hysterectomy. Recently, researchers from the University of Texas Southwestern Medical Center found the data to back up what was once just OB/GYN “common knowledge.”

Reviewing data from the American College of Surgeons National Surgical Quality Improvement Program, the researchers found that the rate of post-operative complications was 1.7% higher in patients with endometriosis. Patients with endometriosis were also more likely to need longer procedures and more procedures at the time of their hysterectomy.

While this may not seem like a terribly high risk, the complications can sometimes be as serious as sepsis, blood transfusions, and the need for post-operative hospital admission. The surgeons at the Outpatient Hysterectomy Center (OHC) take our patients’ well-being very seriously, no matter how low the risk may seem.

Know your hysterectomy options

There are different types of hysterectomies depending on the patient’s health and goals. A supracervical or partial hysterectomy leaves the cervix intact, only removing the upper portion of the uterus. A total hysterectomy includes total removal of the uterus and cervix, usually for cases of cervical cancer, fibroids, or endometriosis. Finally, a radical hysterectomy, often only done for gynecological cancers, removes the cervix, uterus, top of the vagina, and tissues on the sides of the uterus.

A bilateral salpingo-oophorectomy to remove the fallopian tubes and ovaries is sometimes performed in conjunction with a hysterectomy. Research has found that a total hysterectomy combined with a bilateral salpingo-oophorectomy results in a greater decrease in endometriosis pain than a hysterectomy alone.

There are also multiple surgical approaches to a hysterectomy. Minimally-invasive hysterectomies — either a vaginal hysterectomy or a laparoscopic hysterectomy — generally result in the fewest complications. That’s why OHC opts for laparoscopic surgery. We get our patients back on their feet quickly with less pain, bleeding, complications, and recovery time.

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Your choice of doctor matters

The UTSW researchers called up the importance of training doctors and surgeons to be more aware of the potential complications of endometriosis — especially when the endometriosis isn’t noticed until during surgery.

“These data support the need for preoperative diagnostic tools to be able to anticipate and plan for complex endometriosis surgeries so that neither patients nor surgeons are surprised or unprepared for the complexity of a procedure when they are in the operating room,” study leader Dr. Kimberly Kho, a professor of obstetrics and gynecology and associate chief of gynecology at UT Southwestern, said in a news release. “We also need to ensure that surgeons have the requisite skills and are prepared to deal with these often complex cases.”

Dr. Aliabadi and Dr. Yera each have over 20 years of experience in the field of obstetrics and gynecology. They have even been fortunate enough to train other surgeons in their minimally invasive surgical procedures and medical techniques.

Talk to the Outpatient Hysterectomy Center’s expert gynecologists

Whether you’re interested in a hysterectomy or the surgical treatment of endometriosis, Drs. Aliabadi and Yera are here for you. Patients travel from around the country to be treated at the Outpatient Hysterectomy Center, and Dr. Aliabadi even travels to teach her surgical expertise to other doctors. OHC is committed to providing the best women’s health care; our staff chooses the least invasive treatment option whenever possible.

We invite you to establish care with the Outpatient Hysterectomy Center. Please make your appointment online or call us at (844) 863-6700.

The Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.


What are the most common complications of a hysterectomy?

While complications after a hysterectomy are not common, you may experience blood clots or hemorrhaging. Patients with endometriosis are at higher risk of wound or urinary tract infections after hysterectomy.

What to expect after a hysterectomy

Some vaginal bleeding and discharge are expected side effects. For patients who’ve had a hysterectomy with ovary removal a common (expected) side effect is menopause symptoms as your body’s estrogen levels decline. Depending on your age, we might opt for hormone replacement therapy to prevent or delay early menopause.

After a hysterectomy, can you still have endometriosis?

Because endometriosis can spread, removal of the reproductive organs may not be enough to completely cure your endometriosis. Fortunately, recurrence of endometriosis is actually quite low, especially if we manage complete excision of endometrial tissue during your hysterectomy.