This information leaflet provides information about your surgery. The information in this leaflet should already have been explained to you by a doctor. We hope that this helps you to remember what you discussed with your doctor, and also to answer any questions that you may have. If you still have questions after reading this leaflet, then please contact a member of your team on one of the telephone numbers at the end of this leaflet.
What is a radical hysterectomy?
A radical hysterectomy is a surgery to remove the womb including your cervix (neck of the womb). This surgery is mainly done via a midline abdominal incision but – under specific circumstances – can be done laparoscopically or robotically. The aim of the surgery is to remove all of the cancer. If required the pros and cons of removing your ovaries can be discussed with your by your surgeon.
Is there alternative treatment to surgery?
The main alternative is to have radical chemo-radiation therapy. Your doctor will discuss these options with you. This treatment can depend on the stage of the disease. In general there are benefits and risks associated with either option.
Can there be any complications or risks associated with this surgery?
- General anaesthetic carries a small chance of complication. This will be discussed with your anaesthetic doctor before your surgery. It is important to realise that these risks and complications are rare and every care is taken to keep the risks as low as possible.
- Infection- The risk of post-operative infections is reduced by giving ‘preventative’ antibiotics around the time of surgery but infection can still sometimes occur in the chest (3 in 100 cases), wound (5 in 100), pelvis (4 in 100) or urine (10 in 100). Infections are usually easily treated with antibiotics.
- Bleeding (haemorrhage) – This may occur during the surgery or rarely afterwards. Blood transfusion is required in around one in five surgeries. You may need to return to theatre in the rare case of internal bleeding after the surgery.
- Clots (thrombosis) – It is possible for clots of blood to form in the deep veins of the legs and pelvis. This is called a deep vein thrombosis (DVT). This will normally cause pain and swelling in the affected leg and is relatively simple to treat using blood thinning drugs. In rare cases it is possible for a clot to break away and be deposited in the heart or lungs. If this occurs it is a potentially serious complication but several measures will be taken to reduce the risk of this happening. Moving around as soon as possible after your surgery can help as can wearing special surgical stockings and having injections to thin your blood. The risk of developing a DVT is less than 1 in 100 cases.
Risks specific to this type of surgery include:
- Bladder problems – a small number of women will have difficulty emptying their bladder after this surgery. This affects around 2 in every 50 cases. This type of surgery involves operating close to the nerves that supply the bladder affecting the sensation and function. You may need to go home with a catheter in for a period of time and return to the ward for a trial without catheter. If you are unable to pass urine naturally the nurses on the ward will show you how to put a catheter tube into the bladder to make sure it is emptying completely. This is known as intermittent self catheterisation (ISC). This usually settles with time but a small number of women may have long term or permanent problems.
- Lymphoedema – may occur when the lymphatic drainage system becomes blocked and surrounding tissues may swell, causing swelling in the lower body and legs. This can lead to skin problems, pain and discomfort. This can become permanent and can happen months or even years after surgery. Some early research suggests that this will affect less than 5 in 100 of patients having this procedure.
- Lymphocysts or lymphoceles – these are swellings filled with fluid that develop in your abdomen after your surgery. They are often naturally re-absorbed by your body, but if they are larger or causing you discomfort, your surgeon may drain them by using local anaesthetic and a needle.
Consequences of treatment
Following your surgery you may experience some of these problems. Your medical and nursing teams are available to support you and to help to address any problems that may occur.
- If your ovaries are removed – If not already menopausal you will experience Menopause – some of the main physical effects are vaginal dryness, hot flushes, mood changes and low libido (sex drive). This occurs when your ovaries are removed so your hormone levels reduce quickly. How long these symptoms last for is different for everyone. In some cases women can start HRT however this will depend on the outcome of your surgery.
- Fatigue
- Numbness/loss of sensation to the top of your thighs
- Effects on sexual functioning (discomfort, bleeding, reduced libido)
- Emotional/social consequences of diagnosis and treatment
- Change in bladder/bowel habit