SURGERY FOR CANCER OF CERVIX
WERTHEIM'S RADICAL HYSTERECTOMY
For this operation, the surgeon removes the uterus along with the tissues surrounding and next to the uterus (the parametria and the uterosacral ligaments), the cervix, and the upper part (about 1 inch [2-3cm]) of the vagina next to the cervix. The ovaries are not removed unless there is some other medical reason to do so. More tissue is removed in a radical hysterectomy than in a simple one, so the hospital stay can be longer. Some lymph nodes will also be removed and checked for cancer at this time.
This surgery is usually done through a large abdominal incision (also known as open surgery). Often, some pelvic lymph nodes are removed as well. (This procedure, known as lymph node dissection, is discussed later in this section.)
A radical hysterectomy can also be done using laparoscopy or robot-assistance. However, it is very important to note that recent studies have shown that women who have minimally invasive radical hysterectomies for cervical cancer have a higher chance of the cancer recurring and a higher risk of dying from the cancer than those who have surgery through an abdominal incision (open surgery). Having a radical hysterectomy through an abdominal cut is the preferred type of surgery in most cases. Laparoscopic surgery may still be an option for a small specific group of women with early stage cancer, but you should discuss your options carefully with your doctor.
A modified radical hysterectomy is similar to a radical hysterectomy but does not remove as much of the vagina and tissues next to the uterus (the parametria and the uterosacral ligaments).
Possible side effects:
Because the uterus is removed, this surgery results in infertility.
Because some of the nerves to the bladder are removed, some women have problems emptying their bladder after this operation and may need a catheter for a time.
Complications are unusual but could include bleeding, infection, or damage to the urinary and intestinal systems such as the bladder or colon.
Removal of some of the lymph nodes to check for cancer may sometimes result in lymphedema (leg swelling). This is not common, but may happen after surgery and treated with different methods.
Radical hysterectomy does not change a woman's ability to feel sexual pleasure. Although the vagina is shortened, the area around the clitoris and the lining of the vagina is as sensitive as before. A woman does not need a uterus or cervix to reach orgasm. When cancer has caused pain or bleeding with intercourse, the hysterectomy may actually improve a woman's sex life by stopping these symptoms.