Hysterectomy for cervical cancer

Hysterectomy is the usual treatment for early stage cervical cancer. A hysterectomy involves removing the womb and cervix, and occasionally the fallopian tubes and ovaries. A 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 women with cervical cancer 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.

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 before the operation. We also interviewed one woman with early stage cervical cancer, who chose to have a 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.

Describes her experiences prior to hysterectomy.

Age at interview 49

Gender Female

Age at diagnosis 41

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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.

The epidural effectively managed her pain after her hysterectomy and she was surprised by how…

Age at interview 37

Gender Female

Age at diagnosis 32

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Describes the pain she experienced after her hysterectomy.

Age at interview 23

Gender Female

Age at diagnosis 23

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Describes an episode where she had problems with her pain relief after her hysterectomy.

Age at interview 53

Gender Female

Age at diagnosis 51

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Explains why she changed her type of pain relief when she realised morphine was making her feel…

Age at interview 42

Gender Female

Age at diagnosis 40

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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.

Describes her recovery in hospital after her hysterectomy.

Age at interview 37

Gender Female

Age at diagnosis 32

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She didn’t find it painful when the drains were being removed.

Age at interview 37

Gender Female

Age at diagnosis 32

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People recover at different speeds from surgery. Some were playing sports, cycling and horse-riding and going on walking holidays within 3 months. Others found they needed longer to recover. Some had found it very tiring returning to work.

Describes why she felt it important not to overdo things after her hysterectomy.

Age at interview 42

Gender Female

Age at diagnosis 40

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Describes what it was like going back to work after her hysterectomy and suggests doing this…

Age at interview 43

Gender Female

Age at diagnosis 42

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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.

Describes how her emotions were very up and down after her hysterectomy because of hormonal changes.

Age at interview 49

Gender Female

Age at diagnosis 41

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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.

Describes the bladder problems she had for one month after her hysterectomy.

Age at interview 41

Gender Female

Age at diagnosis 39

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Describes the problems she had with her bladder after her hysterectomy.

Age at interview 53

Gender Female

Age at diagnosis 51

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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.

She experienced a change in how her bladder works after her hysterectomy.

Age at interview 37

Gender Female

Age at diagnosis 32

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Her post-operative pain from her hysterectomy affected her ability to drive her car daily to work…

Age at interview 49

Gender Female

Age at diagnosis 41

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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 10 months after her operation.

Describes how she was affected by lymphoedema in her leg and that massage and support stocking s…

Age at interview 43

Gender Female

Age at diagnosis 42

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She couldn’t wear trousers for six months because of her lymphoedema.

Age at interview 35

Gender Female

Age at diagnosis 34

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