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Handling Postoperative Complications in Gynecology

Any surgical procedure is followed by a series of risks and complications. Usually, the risk of postoperative complications depends on the patient’s characteristics such as age, functional status, and comorbidities.

When it comes to postoperative complications in gynecology, there are concerns about the hemorrhage and reopening although there are mainly other complications like that of the bowel, pulmonary, cardiac, renal, and bladder.

There has been a growing trend in the surgical literature to report mortality and morbidity after a postoperative surgery for facilitating meaningful comparisons of surgical outcomes between different surgeons and hospitals.

Specifically, the occurrence of morbidity and mortality after a gynecologic surgery often goes unreported with preoperative risk adjustments for the individual characteristics.

When the patients are wheeled out of the operation theater, doctors are still worried whether the patients are responding well if their pulse and blood pressure are stable, and the output is normal. Besides, tachycardia is another concern for most doctors and surgeons. As it is evident, surgical complications may be minor or life-threatening. Hence, a speedy and sure diagnosis with proper intervention is required throughout the surgery.

Then there are complications that arise after surgical operations,  with some complications more likely to occur than the others. Immediate complications occurring during surgery include those of bowel, pulmonary, cardiac, renal, bladder, etc, or the need to control hemorrhage that requires an immediate surgical response. A cardiac arrest requires a team approach to resuscitation and may also need termination of the procedure.

During the first postoperative week, paralytic ileus (third day), wound dehiscence, pelvic hematoma, secondary bleeding (as late as two weeks), and urinary tract fistula need to be observed.

Besides, for upto 12-18 hours post-surgery, patients are sure to experience tachycardia and peripheral vasoconstriction and so the blood pressure will remain normal. Then, the ability of the compensatory mechanisms is exhausted and patients may even experience sudden hypotension, tachycardia, tachypnea, and abdominal distension. In some cases, there are also chances of intraperitoneal bleeding.

Some of the most important surgery parameters include carefully selecting the patients with suitable indications for operations, expertise of the surgeon, viable surgical techniques, proper knowledge of pelvic anatomy, and a careful postoperative follow-up.

Hence, it is very important for doctors and surgeons to carefully abide by surgery parameters to avoid postoperative complications in gynecology.

To have a better understanding of postoperative complications in gynecology, join this free webinar and gain insightful information about women’s health – Click here to join

Dr. Shobhana Mohandas Consultant Gynaecologist, Sun Medical Centre, Kerala Vice president Elect, Indian Menopause society

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