Diagnosis and Management of Delayed Postoperative Complications in Gynecology: Neuropathy, Wound Complications, Fistulae, Thromboembolism, Pelvic Organ Prolapse, and Cuff Complications

Abstract

Surgical complications are an inevitable occurrence for any surgeon. Such complications may be a source of significant morbidity and even mortality. Delayed surgical complications typically present after the patient is discharged from the hospital. This chapter describes the presentation, evaluation, and management of the most common delayed postoperative complications. Delayed complications may be broadly categorized into those found in the early postoperative period and those in the later postoperative period. The first 2 weeks after surgery is a key time to evaluate and diagnose nerve injuries and wound complications, including infectious complications. Genital tract fistulae and thromboembolism may also present in this time period, but are also commonly seen in the first 3 months after surgery. Pelvic organ prolapse and cuff complications may present months to years after surgical intervention. The surgeon must be vigilant in the postoperative period for any sign of a delayed surgical complication, as prompt diagnosis and management is critical to minimize the effect upon the patient.