Bleeding complications after CASH

We assessed the frequency and studied the possible mechanisms of bleeding after classic abdominal Semm hysterectomy (CASH) in a retrospective, nonrandomized review of 70 women (47 premenopausal) undergoing the procedure with 1-year minimum follow-up. In several women CASH was associated with adhesiolysis, and in more than 50% with bilateral oophorectomy. Of the 47 patients who were menstruating prior to surgery, 6 (13%) reported postoperative menstruation. Two additional patients required repeat surgery, and one required transfusion. Endometrial glands were present in one excised specimen, suggesting the possibility that menstruation and hematometra may occur.