Excessive Sweating is a condition that is caused by an overactive sympathethic system and sympathetic ganglia. Sympathectomy is a surgical procedure that may solve the problem of excessive sweating by inhibiting, cutting or destroying the sympathetic ganglia. Even if the surgery is effective in over 90% of patients, the procedure is complex and it may involve a lot of risks such as low blood pressure, fainting, infertility, chest pain, pneurothorax, increased sweating in other areas of the body or nasal blockage. There are also some surgery risks that need to be considered.  

1. Low Blood Pressure

Following the sympathectomy procedure, some patients may experience low blood pressure especially while standing up, as the removal of the sympathetic nerves may have this effect. This can lead to frequent fainting. The blood pressure may be normalized through medication.

2. Infertility

Sympathectomy in men may cause infertility. This is due to the fact that the semen may not be ejaculated properly (typically in the bladder), and this may affect the patient’s fertility.

However, this problem may not always occur and may only be temporary.

3. Chest Pain

The sympathectomy surgery may be performed with the help of an endoscope, which will be inserted in the chest cavity, allowing the surgeon to monitor the surgery. This procedure may cause chest pain and breathing difficulties after the surgery in certain patients.

However, this problem is only temporary and should go away in 2 to 3 weeks after the surgery.

4. Pneurothorax

The patients that undergo an endoscopic sympathectomy surgery may also be affected by pneumothorax (air gathering in the chest cavity), which is a painful, severe condition that requires laser treatment or surgery.

5. Increased Chest Sweating

The sympathectomy procedure may cause increased chest sweating in over 1/3 of the patients. Patients may also experience increased sweating in other areas of the body. This phenomenon is also known as compensatory hyperhydrosis.

6. Horner’s Syndrome

Horner’s syndrome is a problem of the nervous system that causes eyelid drooping, pupil closing and decreased sweating on one side of the face.

This problem rarely occurs, but may be a sympathectomy complication.

7. Nasal Blockage

In rare cases, nasal blockage may occur following a sympathectomy surgery. This complication may be solved through surgery or medication treatment.

8. Pain in the Ribs Area

Due to the fact that the surgery is performed in the ribs area, the tools can affect the nerves that supply the skin between the ribs and cause pain. The pain may be temporary or permanent.

9. Surgery Risks

In addition to the possible after surgery risks, the sympathectomy procedure may also have surgery risks. Some common surgery risks include excessive bleeding, infections, the formation of blood clots and embolisms or scarring at the incision area. The scarring is minimal if the procedure is less invasive (endoscopic).

Mortality is very low and is typically due to the decreased blood pressure.