Cervical Cancer

Hysterectomy

Hysterectomy is the usual treatment for early stage cervical cancer. A total hysterectomy involves removing the womb and cervix, and occasionally the fallopian tubes and ovaries. A total hysterectomy is only suitable for women with very early-stage cervical cancer (stage 1A1).

A radical hysterectomy is the removal of the womb, cervix, tissue around the cervix (parametrium) and upper part of the vagina. The pelvic lymph nodes are usually removed as part of this operation. Depending on the woman’s age and the type of cancer, removal of the ovaries & fallopian tubes may also be recommended. Most cancers of the cervix are treated with a radical hysterectomy. Sometimes some of the abdominal lymph nodes may be removed in addition to the pelvic lymph nodes during a radical hysterectomy. (Macmillan Cancer Support April 2012)

Surgeons prefer to do this operation laparoscopically for early cervical cancers as it means less time in hospital and a shorter recovery time, but it can only be done in specialist cancer units with specially trained clinicians.

Decisions about whether to have ovaries removed during surgery are discussed between the consultant and the patient prior to the operation. We also interviewed one woman with early stage cervical cancer, who chose to have a 'total' hysterectomy (removal of the womb, cervix and uterus) and her ovaries removed as a precautionary measure (Interview 01).

Several women described their experience before surgery. After surgery, women woke up usually in intensive care. They were connected to an intravenous drip, of fluid and salts until they were able to eat and drink normally, with a catheter (a small tube put in the bladder connected to a small bag to collect urine) in place and drainage tubes coming from the wound.

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A few experienced very little post-operative pain. Others did have abdominal pain but some said this had been effectively managed by either an epidural (a small needle inserted in to the spine prior to surgery) and/or by PCA (patient controlled analgesia, a machine which releases controlled doses of medication at the push of a button). Some experienced problems with their pain control.

Many described feeling very weak and tired, and some felt nauseous, after their operation but within three to four days they were able to walk around. In contrast, one woman who had considerable post-operative pain (see Interview 07 below) said she took longer to recover. A few found the removal of their drainage tubes painful, others didn't.

People recover at different speeds from surgery. Some were playing sports, cycling and horse-riding and going on walking holidays within three months. Others found they needed longer to recover. Some had found it very tiring returning to work.

Some women who had a Wertheim's hysterectomy had both their ovaries removed and they started the menopause, but many found that HRT (hormone replacement therapy) meant that they had few, if any, menopausal symptoms. A few described their emotions as very up and down for a few days after surgery because of hormonal changes.

A few women experienced no long term side effects, apart from a small scar.

Others did have some side effects, including initial or long term bladder problems. Some needed a catheter for a short while after leaving hospital.

Long term bladder problems are unusual but some women did experience these. A woman describes the unusual long term bladder problems she experienced. A few experienced numbness in the area of the surgery and a few experienced bouts of constipation. One had soreness in her throat for many months. Another had considerable post-operative pain but she has found that a TENS unit helped. A third experienced severe constipation, ovarian cysts, a nerve granuloma and reflux oesophagitis which she believed were the result of her hysterectomy.

Some initially felt aware during sexual intercourse that their vagina had been shortened (see 'Sex & sexuality').

Three women developed lymphoedema in the leg or below the scar in the groin area (a swelling caused by the removal of lymph nodes. Massage and support underwear or stockings had helped. One woman had found her operation had restricted her mobility a little, but another was able to go on walking holidays again one year after her surgery. A third was able to wear jeans, swim and play badminton again ten months after her operation.

Last reviewed April 2014.

Last updated April 2014.

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