After surgery for cervical cancer
Your doctors will tell you what to expect after surgery, and what you can do to help your recovery.
After your hysterectomy or trachelectomy you’ll be encouraged to start moving about as soon as possible. This is an essential part of your recovery.
Even if you have to stay in bed, the nurses will encourage you to do regular leg movements and deep breathing exercises. You may be seen by a physiotherapist who can help you do the exercises. You’ll also be given injections of a drug to help prevent blood clots.
Drips and drains
When you get back to the ward, you’ll have a drip (an intravenous infusion) going into a vein in your arm until you’re able to eat and drink normally. You may also have drainage tubes from the wound to drain off any excess fluid. The drip and drains are taken out within a few days.
Usually a small tube (catheter) is put into your bladder to drain your urine into a collecting bag. This is removed when you become more mobile. Some women may have difficulty passing urine once their catheter has been removed and need to have the catheter put back in again. This is usually a temporary problem, and the catheter usually only needs to stay in for 2-3 weeks until normal bladder function returns.
It’s normal to have some pain or discomfort for a few days, but this can be controlled effectively with painkillers. It’s important to let your doctor know as soon as possible if the pain isn’t controlled, so that your painkillers can be changed.
Some women may be given painkillers through an epidural for the first day after surgery. This is a small, thin tube that’s inserted in your back into the space just outside the membranes surrounding your spinal cord. An epidural will give you continuous pain relief.
Other women may have painkillers through a special pump known as a patient-controlled analgesia pump (PCA pump).
If you have a PCA pump it will be attached to a fine tube (cannula), which is placed in a vein in your arm. You can control the pump yourself using a handset that you press when you need more of the painkiller. It’s fine to press the handset whenever you have pain, as the pump is designed so that you can’t give yourself too much painkiller. You will be shown how to use this type of pump.
Some painkillers can cause constipation. Let your nurse know if you have difficulty opening your bowels.
Your hospital team will give you more information about how long you might need to stay in hospital. You may be ready to go home about 3-8 days after an abdominal hysterectomy. If you’ve had laparoscopic (keyhole) surgery or a trachelectomy, you may be able to go home 2-4 days after your operation.
If you think you might have problems when you go home, for example if you live alone or have several flights of stairs to climb, let your nurse know when you are admitted to the hospital, so that help can be arranged.
Before you go home, you’ll be given an appointment to attend an outpatient clinic for your post-operative check-up.
If you need to go home with a urinary catheter, the hospital team can arrange for a district nurse to visit you at home to check how things are.
You’ll be given instructions on how to look after yourself to make sure your wound heals and you recover well. It’s important that you follow the advice you’re given.
If you have a hysterectomy, it’s common to have a vaginal discharge for up to six weeks afterwards. This is usually reddish-brown in colour. If the discharge becomes bright red, heavy, or contains clots, contact your doctor straight away.
To reduce the risk of an infection, use sanitary pads rather than tampons and have a shower or bath every day.
After a trachelectomy it’s normal to have a light reddish-brown vaginal discharge. Your healthcare professionals will let you know how long this discharge is likely to last. You’ll be advised to shower daily and not to have sex or place anything in your vagina (such as tampons) for about six weeks after your surgery. Swimming should also be avoided. This is so the surgical area can heal properly and the risk of infection is reduced.
You’ll be able to go back to your usual sex life, but your doctor will probably advise you not to have sex for at least six weeks after your operation, to allow the wound to heal properly. Many women find they need more time before they’re ready to resume a sexual relationship. Being able to resume a sexual relationship is likely to take more time if you’ve had radiotherapy as well as surgery.
However, this is an important part of your recovery, so don’t be afraid to discuss it with your doctor, specialist nurse or one of our cancer support specialists.
It’s important to avoid strenuous physical activity or heavy lifting for about three months if you’ve had your surgery through an incision in your abdomen. If you’ve had laparoscopic surgery you should avoid heavy lifting and also activities that involve excessive pushing, pulling or stretching for about six weeks. Your physiotherapist or nurse will be able to give you advice about physical activity.
Some women find it uncomfortable to drive for a few weeks after their surgery. It’s probably a good idea to wait a few weeks before you start driving again. Some insurance companies have guidelines about this and it may be helpful to contact your own insurer.
Some women take longer than others to recover from their operation. If you find you’re having problems, it may be helpful to talk to someone who is not directly associated with your illness. Your clinical nurse specialist or our cancer support specialists are always happy to talk to you, and they may be able to put you in touch with a counsellor or a support group in your area, so you can discuss your experiences with other women who are in a similar situation.
Enhanced Recovery Programme (ERP)
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Some hospitals follow an Enhanced Recovery Programme, which can help reduce complications following surgery and speed up your recovery. The programme involves careful planning before your operation, so that you’re properly prepared and any arrangements that are needed for you to go home are already in place. You’ll also be encouraged to start moving around as soon as possible after surgery - sometimes on the day of the operation. Any catheters and drips will be removed soon after surgery, and you’ll also be allowed to eat and drink soon after surgery. After you’ve gone home you’ll be regularly reviewed to make sure that you’re recovering well.
You can ask your doctor whether you’ll be suitable for the ERP - not all hospitals use it for surgery.
Possible long-term complications of surgery
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Most women will have no long-term complications after surgery for cancer of the cervix. However, some women - in particular those who’ve had radiotherapy or chemotherapy as well as surgery - are more likely to develop long-term complications of surgery.
Rarely, women may have bladder or bowel problems after a hysterectomy because of damage to the nerves that control them during the operation. To avoid these problems, surgeons try to not damage the nerves during surgery. This is known as nerve-sparing or nerve-preserving surgery.
If the lymph nodes have been removed, there’s a risk of developing swelling (lymphoedema) in one or both legs.
This is a build-up of lymph fluid that can’t drain away normally because the lymph nodes have been removed. It’s more likely to happen if you’ve had radiotherapy to the pelvic area as well as surgery.
If you develop any problems after your surgery, let your surgeon or nurse know, so that you can get the right kind of help.