What complications may occur after uterine fibroid surgery?

Uterine fibroids are benign tumors, and in most cases, the risk of malignant transformation is low. Although this risk is small, it is not zero. Conventional Western medical approaches often resort to “one-size-fits-all” surgical intervention. While benign uterine fibroids measuring less than 5 cm in diameter generally pose minimal concern, rapidly growing fibroids carry a significantly higher risk of malignancy—up to 27%.

All surgeries entail risks, and uterine fibroid surgery is no exception.

Surgical management of uterine fibroids broadly falls into two categories: myomectomy (removal of fibroids while preserving the uterus) and total hysterectomy (complete removal of the uterus). Surgical approaches include conventional open abdominal surgery as well as minimally invasive techniques such as laparoscopic or transvaginal surgery. Myomectomy is associated with relatively fewer complications; the most common intraoperative risks include bleeding and potential injury to the bowel. In rare instances, dense adhesions may be present around the uterus.

In contrast, total hysterectomy carries a higher incidence of iatrogenic injury. The most frequent postoperative complication remains localized hematoma formation and secondary infection. Occasionally, more serious surgical complications occur—primarily involving injury to the bowel or urinary tract, including damage to the ureters or bladder. If such injuries remain undetected intraoperatively and are not promptly repaired, they may result in postoperative urinary or fecal fistulas—conditions that cause significant distress and necessitate reoperation for repair.