Having a hysterectomy

Title

Having a hysterectomy for cervical cancer involves tests to check you and fit and well for surgery, deciding how the hysterectomy will be done, and having the surgery.

We know that you may feel nervous about having a hysterectomy or worried about any effects of the treatment. It can help to prepare for any treatment physically, emotionally and practically.

Read about preparing for surgery >

On this page:

Tests before hysterectomy >
In the hospital >
During a hysterectomy >
After a hysterectomy >
More information and support >

In this section:

Tests before hysterectomy

You will have a pre-op appointment in the days or weeks before your surgery. You will have some tests to check that you are fit for surgery, including:

blood tests
an electrocardiogram (ECG) that checks the health of your heart.

Your doctor or nurse will explain what will happen during the operation and you will be able to ask questions. Take a list of questions with you and a pen and paper so you can write down answers if you want to.

In the hospital

You will probably be admitted to hospital on the morning of your operation. It might be the night before if you live a long way from the hospital. You will be given some stockings to wear to prevent blood clots from forming in your legs. You’ll wear these during the operation and at home afterwards as well.

You usually need to stop eating at least 6 hours before the surgery. You can usually drink water up to 2 hours beforehand. Your healthcare team will give you specific instructions.

When it’s time to have your procedure, you’ll go into a room next door to the operating theatre. You’ll be in a hospital bed, ready to go into the theatre.

Having an anaesthetic

You will usually have a general anaesthetic. This means you will be asleep for the surgery and won’t feel anything. Your healthcare team will check you are fit and well enough to have it.

An anaesthetist will give you 2 injections – the first to make you fall asleep and the second to make your body numb. Once you’re asleep, you will be wheeled into the operating room.

Some people feel worried about having a general anaesthetic. If you feel this way, you could speak to your healthcare team and anaesthetist before, to find more about what will happen and talk through any concerns.

The anaesthetist will ask you to count to 10 and before you reach 7, you will drift off to sleep. When you wake up, you will be in the recovery room or ward.

Spinal anaesthetic (spinal block) or epidural

You may be able to have a spinal anaesthetic or an epidural. This is an injection in your back that will stop you feeling anything in specific parts of your body. It means you will be awake for the surgery, but you will not feel any pain.

During a hysterectomy

You may have a hysterectomy done in the following ways.

Your surgeon makes a cut in your lower stomach (abdomen). This will be along your bikini line or running down from your belly button. They will then remove the cervix, womb, fallopian tubes and any other areas through this cut.

This type of hysterectomy is done under a general anaesthetic.

Your surgeon will make a cut in the top of the vagina. They will then remove the cervix, womb, fallopian tubes and any other areas through this cut.

This type of hysterectomy can be done:

under a general anaesthetic
using a spinal anaesthetic or an epidural.

Your surgeon does the surgery through small cuts (key holes) in your abdomen. They will use tools that have a tiny camera attached, so that they can see the inside of your body on a screen. They will remove the cervix, womb, fallopian tubes and any other areas through these tiny cuts.

Your stomach will be filled up with gas during the surgery. Your surgeon puts a tube into the cut and pumps carbon dioxide gas in. This inflates your stomach, allowing the surgeon to see your organs more clearly. Once the surgery is done, the gas is let out of your stomach again.

This type of hysterectomy is done under a general anaesthetic.

Robotic surgery

In some hospitals, a robot will assist the surgeon. The surgeon is in the same room but sits away from you and controls the robotic arms to perform the surgery. It allows the surgeon to make more controlled and precise movements. The surgeon is still the one doing the surgery. This is sometimes called robotic hysterectomy.

Making decisions about hysterectomy

Both abdominal (open) and keyhole hysterectomies are effective ways to remove cervical cancer.

There is some evidence that having abdominal surgery has better outcomes. In real terms, some research showed that over 97 in 100 (97.2%) people were alive 4.5 years after abdominal surgery, compared to over 93 in 100 (93.1%) who had keyhole surgery. Experts are not sure why there are differences in survival between keyhole surgery and abdominal surgery. They are planning more research to understand the difference.

The National Institute for Health and Care Excellence (NICE) have guidance that recommends open hysterectomy should be standard practice in treating cervical cancer. This may sound alarming, so it's important to ask questions of your healthcare team to understand the benefits and risks of both types of surgery.

Read about making treatment decisions >

A hysterectomy

An illustraction of two types of hysterectomy showing which parts of the female reproductive system are removed via surgery.

After a hysterectomy

If you have had a general anaesthetic, you will wake up in the recovery room. You will probably feel very sleepy. You may have:

a clear face mask on – this is providing oxygen to help you breathe comfortably
a drip attached to your hand or arm – this is giving you fluids, so you don’t get dehydrated
dressings on your wounds
a tube in your wound (drain) – this lets blood or fluid drain away safely and is normally removed after a few days
a thin tube in your bladder (catheter) – this drains your wee into a bag
a drip into your bloodstream – this has pain medication that you can control (PCA or patient controlled analgesia)
a small thin tube put into your back and connected to a pump – this gives you constant pain medication (epidural).

If you had a vaginal hysterectomy, you will have a type of bandage called a gauze pack inside your vagina. This helps to stop any bleeding. It is usually in place for 24 hours.

Recovering from a hysterectomy

After a hysterectomy, you may need at least 4 to 8 weeks to recover. That includes taking this time off work. You need to be especially careful if you have a job that involves carrying heavy things or lifting.

Read about recovery after surgery >

More information and support after hysterectomy

Any type of surgery for cervical cancer can have a huge impact on your physical and emotional wellbeing. Your healthcare team, both at the hospital and at your GP surgery, are there to support you with any questions or worries you have.

Remember that we are here for you too, whether you are waiting to have surgery, are in recovery, or are years past it. Our trained volunteers can listen and help you understand what’s going on via our free Helpline on 0808 802 8000.

Check our Helpline opening hours >

Our 1:1 service offers a private way to get support over email, phone call or video call. We can talk through your personal situation, as well as helping you process your feelings and think about next steps. We also welcome partners and family members to use our 1:1 service, so if you are a loved one reading this or think yours would benefit from some extra support, get in touch.

Access our 1:1 service >

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum >

If you have general questions about surgery for cervical cancer, our panel of medical experts may be able to help. They can’t give you answers about your individual situation or health – it’s best to speak with your GP or healthcare team for that.

Use our Ask the Expert service >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.

References

NICE (2021). Minimally invasive radical hysterectomy for early stage cervical cancer: Interventional procedures guidance. Web: www.nice.org.uk/guidance/ipg686/chapter/1-Recommendations. Accessed March 2021.
British Gynaecological Cancer Society (2020). Cervical Cancer Guidelines: Recommendations for Practice. Web: www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf. Accessed October 2020.
British Gynaecological Cancer Society (2019). Position Statement on Surgery in Early Stage Cervical Cancer – Lay Summary. Web: www.bgcs.org.uk/wp-content/uploads/2019/07/NCRAS-mas-v-open-radical-hysterectomy-BGCS-lay-statement-May-2019-1.pdf. Accessed October 2020.
Kim, JH. et al (2019). Comparative Effectiveness of Abdominal versus Laparoscopic Radical Hysterectomy for Cervical Cancer in the Postdissemination Era. Cancer Research and Treatment. 51;2. pp.788-796.
Cibula, D. et al (2018). The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiotherapy Oncology. 127;3. pp.404-416.

We write our information based on literature searches and expert review. For more information about the references we used, please contact info@jostrust.org.uk