Q. I am fairly certain that contraception will not be necessary after a hysterectomy but, given that the ovaries remain, I would like to know that ectopic pregnancy would be unlikely to occur in the future as well.
A. An ectopic pregnancy is one which occurs outside the uterus and are always life threatening. If they have been removed, along with the ovaries then this is not possible. If they remain and the ovaries are still functioning then there is a small risk of an ectopic pregnancy occurring. In most cases where the cervix is removed the vagina will be stitched at the top. This means that semen should be contained within the vaginal area. If the cervix is left in-situ then it is stitched at the point at which the uterus is removed.
However, according to the medical literature, there have been 56 reported cases of an ectopic pregnancy post hysterectomy; to put this into perspective, roughly 55,000 women have a hysterectomy in the UK every year so it is incredibly rare, probably a million to one chance!
It happens if the stitching is not complete or there is a tear. If this is the case and you happen to have an ovulated ovum (egg) in your abdomen at the same time as a sperm gets through then there is a slim change the two may meet. As I said though, it is very rare indeed though and will never result in a full-term pregnancy.
Ectopic pregnancy immediately after a hysterectomy is slightly more common (only slightly, remember there have only ever been 56 reported cases!). It is thought to be due to the presence of a fertilised egg before the hysterectomy took place which then implants on one of the other abdominal organs. Again this is a life threatening condition and will not result in a full term pregnancy.
If you are experiencing acute abdominal pain post-hysterectomy you should be scanned to make sure this isn’t the cause of their problems and to identify any potential tears in the stitching or vaginal cuff. Other reasons for acute abdominal pain can include