Your Admission to hospital
The operation you are having is called a radical hysterectomy and pelvic lymphadenectomy. This involves removing the cervix and its surrounding tissue, the uterus and the lymph nodes in your pelvis. Your ovaries and tubes may also be removed if you are near or past menopause.
You are required to check in at the Admission desk in the main foyer of the hospital on arrival. You will then be admitted to the Ward.
Please bring to hospital with you any medications you might be taking, your x-rays, as well as nightwear, toiletries and personal belongings.
Once you have been orientated to the ward the nurse will attend to your admission. This involves asking you a series of questions, as well as taking your blood pressure, temperature, pulse and weight.
An anaesthetist will also see you to discuss your anaesthetic and post operative pain management.
Preventing complications
To help reduce the risk of clots in your legs you will be given support stockings to wear. You will also be given Clexane injections and wear calf compression devices (SCCDs) to assist with this. An enema will be given the night before your operation to help empty your bowels
Your Operation
On the morning of your surgery you should have a shower and put on a theatre gown. A shave of your abdomen and pubic area maybe required. You may be given a premedication to help you relax.
A nurse from the unit will escort you to theatre, where you will be checked in and taken to the anaesthetic bay. An intravenous drip and possibly an epidural will be inserted. You will then be taken into the operating theatre and anaesthetised.
Your surgery will take approximately 2-3 hours. You will then be taken to the recovery room, where you will wake up, before returning to the ward. Depending on your blood pressure and pain relief you may be in recovery for up to 2 hours.
After your Operation
Our team is here to assist you in anyway we can during your hospital stay and recovery.
On return to the ward the nurses will monitor you closely. You will have an intravenous drip in your arm and an infusion for pain relief. A catheter will be in place, draining urine from your bladder. You may also have a drainage tube coming from your abdomen.
The incision in your abdomen will usually be vertical (up and down). There will be no visible stitches. You will be allowed to eat clear fluids the day after your operation and progress once you pass wind. You will be assisted to wash and mobilise as required. A physio may show you how to do breathing and leg exercises. Some vaginal bleeding following surgery is expected and will be monitored.
Your Discharge from hospital
The usual length of stay for this surgery is 5 days.
Prior to your discharge you will be given information about what to do during your recovery.
An appointment will be made for you to see your doctor in 6 weeks.
At your appointment the doctor will explain the results of your surgery again and any further treatment you may require.
We will continue to see you for follow up at regular intervals.
Possible Complications of Surgery
Haemorrhage
The operation may involve removing tissue from the walls of major veins and arteries. The average blood loss is 200-500 ml and occasionally of patients will require a blood transfusion.
Infection
A minor infection of the wound or the bladder occurs in up to 20% of patients. Severe infections are rare.
Bladder Problems
1-3% of women have ongoing difficulty passing urine as a result of the operation. In extreme cases the bladder needs to be emptied with a catheter a few times a day for a period after the surgery.
Damage to Surrounding Organs
It is possible that the bladder, ureter or bowel may be damaged during the operation. These injuries are uncommon and rarely if they occur result in fistulae.
Clots
Blood clots may develop in the veins of the legs or pelvis. A clot can rarely travel to the lungs causing breathing difficulties and in extreme cases even death.
A number of precautions including support stockings, anticoagulant injections, calf compressors, leg exercises and early mobilization are taken to decrease the risk of clot formation.
Anaesthesia
There is approximately a 1 in 100000 chance of dying from anaesthesia. However a number of minor complications can occur (e.g. broken tooth, sore throat). Discuss any concerns with the anaesthetist before the operation.
Pain
Any surgery causes a degree of discomfort. Post operative pain relief is a priority for our patients and options for analgesia will be discussed with you.
The above list covers the main possible side effects and complications of your surgery but is by no means complete. Please discuss with your doctor any specific concerns you may have about the proposed procedure.
The list of complications appears daunting but the overall risk of a major complication is low.
Results of Treatment
Your surgery can have a number of outcomes:
The cancer has been completely removed and the lymph nodes do not show any cancer. In this case no further treatment is required. Your chance of the cancer returning is less than 10%.
The cancer has been removed and the nodes are clear but the microscopic appearance of the tumour suggests there is an increased risk of recurrence. This occurs in 5-10% of patients and further treatment will be offered in the form of radiation therapy, possibly with concurrent chemotherapy. The chance of cure is still 80%.
The cancer could not be completely removed and/or it is present in tissues outside the cervix such as the lymph nodes. You will be offered further treatment, usually in the form of radiation therapy, often with concurrent chemotherapy. In this case complete cure is possible but less likely.
