Bigger Women May Seek Smaller Cuts

Hysterectomy complications greater in overweight women but they have other options

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) There is more than one way for a woman to get a hysterectomy, the procedure that removes a woman's uterus. Overweight women may want to explore those options.

A recent study found that overweight and obese women may have a greater risk of complications from hysterectomies than women at a healthy weight.

The authors noted, however, that medical advances have increased the number of options for minimally invasive hysterectomy.

Minimally invasive means the doctors use a very small cut instead of a large one. Using smaller incisions can reduce the likelihood of some of the complications of a more traditional hysterectomy.

"Ask a surgeon about minimally invasive hysterectomy."

The study, led by Nima Khavanin, BS, of the Department of Surgery at Northwestern University's Feinberg School of Medicine in Chicago, looked at the influence of women's weight on their surgical outcomes after they had hysterectomies.

The researchers used a data set from a group of hospitals where 9,917 women received hysterectomies between 2006 and 2010.

The data included the women's body mass index (BMI) measurements. BMI is a ratio of a person's height to weight and is used to determine whether someone is a healthy weight.

A BMI between 18.5 and 25 is considered healthy or "ideal." Women with BMIs between 25 and 30 are considered overweight. A BMI of 30 or greater is considered obese.

Of the patients in the study, 2,219 of the women who got hysterectomies had an ideal BMI. Another 2,765 were overweight, and 4,933 were obese.

Across all the procedures, 11.3 percent of the women experienced complications associated with the hysterectomies. These were more common among obese women.

Approximately 13.2 percent of obese women experienced complications, compared to 9.7 percent of overweight women and 9 percent of women with healthy BMIs.

It was rare for women to experience surgical complications, which included infections that developed during surgery or wounds that opened up afterward. However, these complications were more common among obese women.

Overweight women were 1.6 to 1.7 times more likely to experience surgical complications or wound infections compared to women of a healthy weight.

Obese women were three times more likely to experience surgical complications or wound infections.

Overweight patients were also 4.6 times more likely than women with an ideal BMI to experience major blood clots, called deep vein thrombosis.

Obese women were 1.4 times more likely than women with ideal BMIs to experience any kind of complication, and they were 3.6 times more likely to have their wounds open up after surgery.

The authors noted that there have been significant advances in minimally invasive forms of hysterectomy. Such advances have led to "...significant decreases in the number of abdominal hysterectomy procedures performed each year," the authors wrote.

Fewer abdominal hysterectomy procedures means fewer opportunities for complications such as the ones that obese women are at higher risk for experiencing.

"With this in mind, it may be beneficial for clinicians to first consider minimally invasive approaches in obese and overweight patients," the authors wrote.

The study was published in the June issue of the American Journal of Obstetrics and Gynecology.

The internally funded research used data from the National Surgical Quality Improvement Program of the American College of Surgeons and participating hospitals. The authors report no conflicts of interest.

Review Date: 
June 27, 2013
Last Updated:
September 6, 2013