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Risks and side effects of trachelectomy

Trachelectomy can cause some short-term and long-term effects that may affect your physical and emotional wellbeing. 

Everyone’s recovery is different and not everyone gets all these side effects, but it can help to be prepared. Your healthcare team will explain potential side effects to you in more detail.

Read about recovering from treatment >

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Problems during surgery

During a trachelectomy, there is a risk of complications such as:

  • bleeding
  • cuts made to the tubes connecting your bladder and kidneys (ureters), bladder, bowel or blood vessels.

These complications can normally be treated during the surgery. 

Pain

After a trachelectomy, you can expect some pain where your surgeon made the cut. This can last for about 4 to 6 weeks, although it should get better day-by-day. 

The level of pain varies from person to person. If you are in a lot of pain or find it is affecting your day-to-day life, talk to your healthcare team. They can advise on prescribed pain medication or over-the-counter pain medication, offer reassurance based on your medical history and, if needed, will be able to check you are healing properly.

Vaginal bleeding and discharge

You will probably have some light bleeding from your vagina and more discharge than usual. This can last for up to 6 weeks after surgery. It is best to avoid tampons while this is happening – use a period pad instead.

You must tell your healthcare team straight away if you:

  • notice heavy bleeding – are soaking through a period pad every hour
  • start passing blood clots
  • have vaginal discharge that smells badly.

These may be signs of an infection, which your healthcare team can treat.

Cervical stenosis 

The opening of the cervix (the os) can narrow or close and become scarred after trachelectomy. This is called cervical stenosis. If this happens, the passage between the womb and vagina may become partly or fully blocked. 

Research suggests that over 1 in 10 (10.5%) women and people who have a trachelectomy will have cervical stenosis. It can cause painful periods or infections.   

You may not have any symptoms of cervical stenosis. If you have periods, they might become irregular or painful. If you are trying to become pregnant, the sperm may not be able to get to the womb.

Sometimes blood from periods gets trapped inside the womb because the cervix has become too narrow. If this happens, you will need to have a small operation to open the entrance to the womb. 

If you are worried about cervical stenosis or think you may have it, speak with your healthcare team. They can offer support and practical ways to help, like using a thin tube (dilator) with lubricant to help open the cervix. 

Lymphocysts or lymphoceles

Swellings filled with fluid can develop in your stomach (abdomen) after a trachelectomy. These may be lymphocysts or lymphoceles.

Sometimes they go away on their own, but if they are larger or causing discomfort, your surgeon may drain them using local anaesthetic and a needle.  

Bladder problems

You may have problems weeing and might get urine infections. These can be treated with:

  • a catheter to drain your wee – this is a thin tube that can be put into your bladder for a short time
  • antibiotics.

Let your healthcare team know about any bladder problems, so they can give you treatment or support. 

Read about catheters on the NHS website > 

Changes to your sex life

You may find that your sex life is affected after a trachelectomy. This may be because of the surgery itself, or the emotional impact of being diagnosed with cancer and having treatment. This is common and it can take some time to recover, but things usually do get better.   

You might worry about whether sex will feel the same after trachelectomy. If you were able to have orgasms before, you should be able to have them again. Your vagina will be shorter after the operation, but it can stretch using dilation therapy or during penetrative sex. You could try vaginal lubrication – this can be prescribed by your GP, or you can buy it at a chemist, supermarket or order online. 

It can help to start off gently. If you find things uncomfortable, wait a week and then try again. Any discomfort or pain should get better over time. If it does not, tell your healthcare team so they can support you. 

Read more about sex after cervical cancer >  

Pregnancy after trachelectomy

It is possible to become pregnant after trachelectomy, but you have more chance of having a miscarriage or giving birth early (a premature birth).   

Read about fertility and trachelectomy > 

Lymphoedema

After trachelectomy, you might have some swelling in your:

  • groin 
  • one or both of your legs

This is called lymphoedema. It is caused by a build-up of lymph fluid that can’t drain away because the lymph nodes have been removed. It is more likely to happen if you have had radiotherapy as well as surgery.  

Read about lymphoedema >

More information and support about trachelectomy

Any type of surgery for cervical cancer can have a huge impact on your physical and emotional wellbeing. You may also still be processing a cervical cancer diagnosis or preparing for more treatment.

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 for surgery, have just had it, 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

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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. 

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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.

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If you have general questions about the effects of surgery, 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

  • 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.
  • Xiaoqi, Li. et al (2015). Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review. European Journal of Cancer. 51;13. pp.1751-1759.
  • Royal College of Obstetricians and Gynaecologists (2013). Fertility Sparing Treatments in Gynaecological Cancers. Scientific Impact Paper No. 35. Web: www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_35.pdf. Accessed October 2020.

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

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Date last updated: 
03 Nov 2020
Date due for review: 
01 Nov 2023
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