A study at Gloustrup University Hospital (Denmark) investigated the effect of body mass index (BMI) on the risk of complications after surgery to remove the uterus due to mild changes, as well as the effect of various types of surgery on the incidence of complications.

The cohort study included health and lifestyle data collected prospectively for all women who underwent hysterectomy for mild changes for the period 2004-2009. To assess the possible effect of BMI on the incidence of postoperative complications during the first 30 days after surgery, the logistic regression method was used.

Among the 20,353 women for whom a complete list of data was collected, a body mass index of 6% BMI was less than 20 kg / m², 31.9% of BMI was 25-30 kg / m²; (considered overweight) and a BMI of 17.5% was greater than 30 kg / m²; (considered obesity). The overall complication rate was 17.6%, with bleeding being the most common specific complication (6.8%). After adjusting for age, ethnicity, education, indications for surgery, uterine weight, prophylaxis used, classification by the American Society of Anaesthesiologists, concomitant diseases and the type of hysterectomy performed, it was found that obesity was associated with an increased risk of developing severe bleeding during surgery (odds ratio 3.64), all complications associated with bleeding (ratio of odds 1.27) and onnyh complications infection (odds ratio 1.47). The risk of all complications associated with bleeding (odds ratio 1.48) and the risk of reoperation (odds ratio 1.66) also increased in women that the BMI did not exceed 20 kg / m².

The U-shaped relationship between BMI and the occurrence of bleeding, as well as the relationship between a high BMI and the development of infectious complications, has only been demonstrated with abdominal access (abdominal hysterectomy). The risk of infectious complications increased in women with a BMI less than 20 who had a laparoscopic hysterectomy.

Thus, obesity increases the risk of bleeding and infectious complications after an abdominal hysterectomy, and urinary tract infections below 20 increase the risk of bleeding and the development of infectious complications after an abdominal hysterectomy and a laparoscopic hysterectomy, respectively.