Cervical Cancer - Treatment for Cervical Cancer

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Total Hysterectomy. A total (also called simple) hysterectomy involves the removal of the uterus and the cervix, but leaves the parametrium (tissue surrounding the uterus) and vagina intact. Lymph nodes in the pelvis are not usually removed. The uterus may be removed through an open abdominal incision or vaginally. There are various ways to perform vaginal hysterectomy, including laparoscopically. A simple hysterectomy is usually performed to treat stage IA1 cervical cancer. [For more information on hysterectomy procedures, see In-Depth Report #73: Uterine fibroids and hysterectomy.]

Click the icon to see an illustrated series detailing a hysterectomy.

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Radical Hysterectomy. A radical hysterectomy removes not only the uterus and the cervix but also the parametrium, the supporting ligaments, the upper vagina, and some or all of the pelvic lymph nodes (a procedure called lymphadenectomy). The fallopian tubes and ovaries are not usually removed, (a procedure called bilateral-salpingo-oopherectomy) unless there are other medical reasons for doing so. Radical hysterectomy is used to treat cervical cancers in stages IA2, IB1, and IB2.

Pelvic Exenteration. If the cancerous tumor recurs within the pelvis after primary treatment, the patient may need a more extreme procedure called a pelvic exenteration, which combines radical hysterectomy with removal of the bladder and rectum. (In such cases, plastic surgery may be needed afterward to recreate an artificial vagina.)

Recovery. Hospital stays for simple hysterectomy range from 1 - 2 days for vaginal hysterectomy to 3 - 5 days for abdominal hysterectomy. Total recovery time is generally 2 - 3 weeks for vaginal hysterectomy and 4 - 6 weeks for abdominal hysterectomy. Radical hysterectomy generally requires a 5 - 7 hospital stay and about a 6-week recovery period.

Side Effects. Side effects include difficulty emptying the bladder or bowels and a painful lower abdomen (if an abdominal incision was used). Normal activity, including intercourse, can be resumed in about 4 - 8 weeks. The effects of hysterectomy on sexuality vary among women. Some women note a change in their orgasmic response because they no longer experience uterine contractions.