Before and after surgery for cervical cancer
Your surgeon will discuss your surgery for cervical cancer and how you can prepare. We have information about what to expect before and afterwards.
If you smoke, try to give up or cut down before your operation. This will help reduce your risk of chest problems and will help your wound to heal after the operation. Your GP can help you if you want to give up smoking.
If you are having a hysterectomy or trachelectomy, you will go to a pre-assessment clinic a few days or weeks before the operation. You will have tests to check you are fit for surgery, such as blood tests and an echocardiogram (ECG) to check your heart.
A member of the surgical team and a specialist nurse will explain the operation to you. Make sure you discuss any questions or concerns you have about the operation with them. You will also see the doctor who will give you your anaesthetic (the anaesthetist). They will talk to you about the anaesthetic and explain how your pain will be controlled after the operation.
You will usually be admitted to hospital on the morning of your operation. You will be given elastic stockings (TED stockings) to wear during and after the operation. These prevent blood clots forming in your legs.
How quickly you recover will depend on:
- the type of operation you have
- whether you had abdominal or laparoscopic surgery.
You will be encouraged to start moving around as soon as possible. While you are in bed, it is important to move your legs regularly and do deep breathing exercises. This is to help prevent chest infections and blood clots. You will also have daily injections of a blood-thinning drug to reduce the risk of blood clots.
If you have had lymph nodes removed, you will be encouraged to put your feet up when you are sitting. This helps to reduce leg swelling.
Drips and drains
You will be given fluids into a vein in your hand or arm. This is called a drip or an intravenous (IV) infusion. This will be taken out as soon as you are eating and drinking normally.
You may have a drainage tube in your wound or tummy (abdomen) to drain excess fluid into a small bottle. The drain is usually removed after a few days.
You will have a tube (catheter) to drain urine from the bladder. It may be taken out a few hours after your surgery, or the next day. This depends on what type of surgery you have had. You may go home with the catheter still in place. It can be removed at a follow-up appointment or by a community nurse.
After a radical hysterectomy or trachelectomy, you may have difficulty passing urine (peeing) when the catheter has been removed. This is temporary. If it happens, a catheter is put into the bladder for 2 to 3 weeks until the bladder recovers. You can be at home while the catheter is place.
It is normal to have some pain or discomfort for a few days after surgery. But this can be controlled with painkillers. If the painkillers are not working, it is important to tell your doctor or nurse as soon as possible. They may change the dose or give you different painkillers.
Immediately after your operation, you may have strong painkillers. You may be given painkillers through one of the following:
By injection into a muscle
By injection into a muscle. This is done by a nurse.
An epidural. This is a small, thin tube in your back that goes into the space around your spinal cord. An epidural gives you continuous pain relief via a pump. You will not be able to walk around if you have an epidural in place.
A patient-controlled analgesia pump (PCA pump)
The pump is attached to a fine tube (cannula), in a vein in your arm. You control the pump using a handset that you press when you need more of the painkiller. It is fine to press the handset whenever you have pain. The pump is safe as it is set so that you cannot give yourself too much painkiller.
As pain starts to improve, you will be given milder painkillers as tablets. You may be given a supply to take home.
The surgeon will close your wound using clips, stitches or sometimes skin glue. Clips or stitches are usually removed after you go home. A nurse at your GP practice can do this. Some stitches, called dissolving stitches, are absorbed by the body and do not need to be removed.
Wound infections can be a complication of the surgery. Signs of wound infection include:
- fluid or pus coming from the wound
- feeling unwell
- a fever or high temperature.
Tell your nurse or doctor if you have any of these symptoms, even after you go home. If you are unable talk to your hospital team, tell your GP or out-of-hours service.
If you are having problems being able to poo after surgery, tell your doctor or nurse. They can give you a laxative to help your bowels move. See your GP if you have problems after being discharged from hospital. It can help to drink at least 2 litres (3½ pints) of fluids each day. It can also help to eat high-fibre foods, such as fruit, vegetables and wholemeal bread.
You may feel low in mood about 3 days after surgery. This may last for 24 to 48 hours. It is a normal reaction to a stressful event such as surgery after being diagnosed with cancer. Your nurse specialist will be able to support you.
We have more information about other ways to find support.
Before you go home, you will be given an appointment to attend an outpatient clinic. This is so you can get the results of the operation and have your post-operative check-up.
A member of your healthcare team will give you instructions on how to look after yourself as you recover.
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.
If you have any concerns, talk to the nurse about these. It is important that you follow the advice you are given.
It is important to continue with daily blood-thinning injections for 4 weeks after the operation. You will be given a supply of injections to take home. A nurse will show you how to inject yourself. If you are not able to inject yourself, they will show a family member or friend how to do this. They may be able to arrange for a district nurse to do it for you.
After a hysterectomy or trachelectomy, you may have a vaginal discharge for up to 6 weeks. This is usually reddish-brown in colour. Contact your doctor or specialist nurse straight away if the discharge:
- becomes bright red
- is heavy
- smells unpleasant
- contains clots.
For the first 6 weeks after surgery, your doctor or nurse will advise you:
- to shower daily
- not to have sex
- not to place anything in the vagina (such as tampons)
- avoid swimming or bathing.
This is so the surgical area can heal properly and to reduce the risk of infection.
Not having sex for at least 6 weeks after your operation gives your wound time to heal properly. After that, you can have sex. But it is normal to need more time before you feel ready, especially if you are having other treatments.
It is important to balance some gentle activity with rest after an operation. Gentle activity such as short walks or sitting exercises can help reduce the risk of blood clots, chest infections and build energy levels. Your physiotherapist or nurse can give you advice about physical activity that are safe for your situation.
You should avoid strenuous physical activity for several weeks after your operation. This is usually for about 6 weeks after laparoscopic surgery and for about 12 weeks after abdominal surgery. You will need to avoid:
- activities that make you breathless, such as running or going to the gym
- anything that involves heavy lifting, pushing, pulling or stretching.
Your physiotherapist or nurse will be able to give you advice about physical activity.
You may find it uncomfortable to drive for a few weeks after surgery. Ask your nurse or doctor for advice on when it will be safe for you to start driving again. Some insurance companies have guidelines about this. You may want to contact your insurer to check you are covered to drive.
This can happen if nerves in the tissue around the cervix need to be cut to remove the cancer. This can affect your bladder, bowel or sexual response. Your surgeon may use nerve-sparing or nerve-preserving surgery to reduce the risk of these complications.
If your lymph nodes have been removed, there is a risk you will develop swelling in one or both legs. This is called lymphoedema. It is caused by a build-up of lymph fluid that cannot drain away because the lymph nodes have been removed. It is more likely to happen if you have radiotherapy or chemoradiation to the pelvic area after surgery.
If you develop any problems after your surgery, tell your surgeon or nurse so that you can get the right help.
Most people do not have long-term complications after surgery for cervical cancer. But, if you have radiotherapy or chemoradiation as well as surgery, you are more likely to develop long-term complications.
Some people take longer than others to recover from their operation. If you are having problems, it may be helpful to talk to someone.
Your clinical nurse specialist or our cancer support specialists are always happy to talk to you. Call us on 0808 808 00 00. 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 others who are in a similar situation.
You can also visit our Online Community to share experiences and information with others going through the same thing.
Below is a sample of the sources used in our cervical cancer, cervical screening and CIN information. If you would like more information about the sources we use, please contact us at email@example.com
GOV.UK. Cervical screening: programme overview. Updated 18 November 2019. Available from www.gov.uk/guidance/cervical-screening-programme-overview (accessed March 2020).
GOV.UK. Colposcopic diagnosis, treatment and follow up. Updated 5 February 2020. Available from www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/3-colposcopic-diagnosis-treatment-and-follow-up (accessed April 2020).
Marth C, Landoni F, Mahner S, et al. Cervical cancer: ESMO clinical practice guidelines. Annals of Oncology, 2017; 28, suppl 4, iv72–iv83. Available from www.esmo.org/guidelines/gynaecological-cancers/cervical-cancer (accessed October 2020).
Reed N, Balega J, Barwick T, et al. British Gynaecological Cancer Society (BGCS) cervical cancer guidelines: recommendations for practice. 2020. Available from www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf (accessed October 2020).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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We want everyone affected by cancer to feel our information is written for them.
We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.
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