CME Review ArticleEarly Complications of Abdominal and Vaginal HysterectomyHarris, Wesley J.Author Information East Tennessee State University Quillan College of Medicine, Johnson City, and Department of Obstetrics and Gynecology, Bristol Regional Medical Center, Bristol, Tennessee. Reprint requests to: Wesley J. Harris, MD, Department of Obstetrics and Gynecology, Bristol Regional Medical Center, 249 Midway, Bristol, TN 37620. Authors whose names are accompanied by an asterisk (*) have indicated, in accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards, that they have a relationship which could be perceived by some people as a real or apparent conflict of interest, but do not feel it has influenced their participation. Obstetrical & Gynecological Survey: November 1995 - Volume 50 - Issue 11 - p 795-805 Buy Abstract In 1982, the Collaborative Review of Sterilization (CREST) study was published, reviewing the complications accompanying and following both abdominal and vaginal hysterectomy. This review was undertaken to see how these rates have changed in the ensuing years. All large series of abdominal and vaginal hysterectomy complications published subsequent to the CREST study were reviewed. Additionally, other studies that focused on specific complications were reviewed. It is concluded that the following changes related to hysterectomy morbidity have occurred since the publication of the CREST study: 1) the use of blood transfusion has diminished due to concern regarding human immunodeficiency virus contamination; 2) the rate of urinary tract infection has decreased primarily due to routine use of prophylactic antibiotics; and 3) inadvertent injury to the bladder has been noted more frequently at a rate of 1 to 2 percent. A particularly important category of complication is "unintended major surgical procedures which accompany or follow hysterectomy." This has been shown to occur at a rate of approximately 4 percent on general gynecology services. Finally, risk factors that add to the morbidity of hysterectomy are discussed. © Williams & Wilkins 1995. All Rights Reserved.