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What causes chills and fever post transvaginal hysterectomy?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
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Practicing since : 1998
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Question
Hello. I'm 66 yo. Had transvaginal hysterectomy/bladder prolapse repair July 1 of this year. July 13 in a.m. I had extreme chills and fever. Doctor had me admitted for three nights. CAT scan showed 2" x 4" liquid sack in area of surgery. Doc said they would be unable to aspirate it. I'm now home and taking two antibiotics. O.k. so far. What usually causes these infections? Anything else I can do? Thanks!
Also, I read that women who have complications usually are obese and/or diabetic or smokers. I am none of these.
I've had early morning night sweats since I've come home.
Posted Sat, 9 Aug 2014 in General Health
 
 
Answered by Dr. Aarti Abraham 26 minutes later
Brief Answer:
VAGINAL VAULT HEMATOMA, COMMON COMPLICATION.

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
What you have got is called a vaginal vault hematoma.
This is very common after a vaginal hysterectomy, with incidences ranging from 25 % to 98 % in most studies.
Obesity, diabetes, smoking, non - ambulation are risk factors for wound sepsis and wound infection.
However, for a vaginal vault collection, the most important factor is surgical technique.
SO please do not blame yourself or look to yourself as a culprit.
Almost more than 50 % of women have small or big amount of such fluid collection in the pelvis following a hysterectomy.
Yours is a moderate sized collection, the problem is that with fever and chills, it indicates that there is infection.
Unluckily, it must be situated in such a position that they are unable to drain it - drainage is the quickest and most effective solution.
In absence of drainage, you need to wait for it to spontaenously get absorbed as the fluid will seep back into the peritoneal spaces.
It will take time.
The antibiotics should be diligently taken to avoid risk of florid infection setting in.
What you can do is ambulate moderately.
Take the antibiotics without skipping a dose.
Keep a tab on your fever, and if it is persistently elevated inspite of antibiotic coverage, report back to your doctor.
Avoid undue strain such as intercourse, bending, lifting weights or unaccustomed postures.
Take a hot water bottle if there is too much of pain.
Keep in touch with your doctor and have a follow up scan after the antibiotic course is completed.
All the best
Please feel free to discuss further.
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