Diagram showing the parts of the body removed with a radical hysterectomy. (Image courtesy CRUK/Wikimedia Commons.)
Surgery for cervical cancer
There are different types of surgery used for cervical cancer.
About cervical cancer surgery
Surgery aims to remove the cancer and the area close to it. There are different ways of doing surgery for cervical cancer, depending on the stage of your cancer. Types of surgery include:
LLETZ (large loop excision of the transformation zone)
Removing abnormal cells in very early cervical cancer using a thin wire loop and electrical current.
Cone biopsy
A cone-shaped piece of tissue is removed from the cervix. This is usually done with a general anaesthetic.
Hysterectomy
The cervix, uterus and fallopian tubes are removed.
Radical hysterectomy
The cervix, uterus and top part of the vagina are removed
Salpingo-oophorectomy
One (unilateral) or both (bilateral) of your ovaries are removed.
Lymphadenectomy
The lymph nodes in the pelvis are removed. This operation may be done along with one of the above operations or before you start radiotherapy.
Radical trachelectomy
The cervix, the tissue around the uterus and part of the upper vagina are removed.
Diagram showing the parts of the body removed with trachelectomy surgery. (Image courtesy of CRUK/Wikimedia Commons.)
Ways of doing cervical cancer surgery
Keyhole or open surgery?
- Open surgery is where the surgeon operates through a cut (incision) in the abdomen (tummy wall).
- Laparoscopy (keyhole surgery) is done through small openings in your abdomen (tummy wall).
It usually takes less time to recover from keyhole surgery. However, your doctor will explain the surgery options to you and which they feel is best for you.
Recovering from cervical cancer surgery
When you wake up, you may have some tubes attached to your body, such as a drip in a vein in your arm or drainage tubes at the site of your wound. You may also have an oxygen mask over your face. This is normal after an operation like this.
You may feel pain in the first few days after open surgery. Always tell your doctor or nurse if you are in pain, as they can give you medicine to help. After keyhole surgery, you may experience wind-type pain or cramps. This pain can be quite severe but this is normal. A combination of medication, peppermint water and moving around may help.
You will be more at risk of getting an infection after surgery. For example, a urinary tract infection. You may be prescribed antibiotics after surgery.
For the first 6-8 weeks, it is normal to experience vaginal bleeding or discharge at times. After leaving hospital, if you experience heavy vaginal clotting or bleeding or have a foul-smelling discharge, contact your specialist nurse or doctor immediately.
You may get constipated (find it hard to pass a bowel motion (poo)), as your bowels may be sluggish after surgery. You may need to take a laxative for a few months.
You might find it is hard to empty your bladder if you’ve had a radical hysterectomy. You may have a tube (catheter) to drain your bladder for a day or two after surgery.
After the tube is removed, your bladder may still be slow and need to be emptied with a catheter on and off.
Surgery in your pelvis puts you at risk of clotting in the deep veins of your legs and body. This is called deep vein thrombosis (DVT).
You may be given injections to prevent this for a month after surgery. You or a member of your family will be invited to learn how to give the injection. It is very easy.
Getting up and about and exercising your legs is most important in preventing DVT.
Lymphoedema is a build-up of fluid in your legs, which can make them swell up. This can happen any time after your surgery if your lymph glands are removed. When the glands are removed, they can no longer drain away excess fluid in your body. Read more about lymphoedema.
Very rarely, serious complications happen after radical surgery. These can include leakage from the bladder or bowel or narrowing of the tubes that bring the urine from the kidneys to the bladder. You may need more surgery to help these problems.
Fertility
If you have a hysterectomy, you will no longer be able to have children. This can be very difficult to deal with and you may need extra support to cope. With other surgeries you might need extra pregnancy care.
Going home
Most patients are ready to go home 4-5 days after open surgery. With keyhole surgery, you may be ready to go home after 1-2 days.
Your doctor or nurse will discuss things you should do and things to avoid during your recovery
You should avoid strenuous activity (including heavy housework), heavy lifting and driving for 2-3 weeks, or for 6 weeks if you have had open surgery.
Whichever type of surgery you have, you will be encouraged to walk regularly, increasing the time spent walking every day. Your nurse or physiotherapist will discuss this with you in more detail. You should avoid strenuous exercise, such as jogging or swimming, until you have healed.
Avoid sex for up to 6 weeks to let the top of the vagina heal.
Going back to work
You should be able to go back to work 4–6 weeks after surgery, depending on the kind of work you do.
Talk to a Cancer Nurse
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