LETTERS

The reality of complications at complex vaginal hysterectomy

It is imperative that I clarify the section on complications in my Surgical Techniques article “Complex hysterectomy: opting for the vaginal approach” [April]. Due to a misinterpretation, it was incorrectly stated that “bladder perforation and ureteral damage (entrapment or severance) are common complications of complex vaginal hysterectomy.”

Although bladder perforations and ureteral damage are major concerns with complex vaginal hysterectomy, such mishaps are, in fact, uncommon because of the precise surgical techniques involved. In fact, the risk for these complications is greater with the abdominal approach because it is more difficult to access the lower urinary tract. It is fear of these potential complications that is common, not their actual occurrence.