January 7, 2018

Hysterectomy for Cancer

Radical Hysterectomy

Hysterectomy for Cancer. A complex, challenging and technically intensive procedure done for Cancers of the Cervix and Uterus. Procedure involves removing the uterus with a wide margin of normal tissues, while saving the ureters and delicate nerves to the bladder. It is a surgical art in need of patience, persevarence and dextirity with years of practice from the surgeon for best outcomes!

Cancer Cervix

Cervical Cancer is one of the commonest cancers in india affecting women around 40 years. Presents with bleeding in the early stage. It is caused by HPV Viral infection. Stage 1 and 2 cancer cervix is treated by surgery with Radical Hysterectomy and results in cure. (Hysterectomy for Cancer)

Cancer Uterus

Cancer of Uterus also Cancer Endometrium is commonly seen in peri and post menopausal women. Clinically presents early as bleeding is the first complaint and happens at a very early stage of the disease. This is treated with Type 1 and some times Type 2 Radical hysterectomy (Hysterectomy for Cancer).  

What is done?

The entire uterus along with adjacent normal tissues are removed.Fallopian tube along with upper vagina is also removed. Sometimes the ovaries also removed. Lymph nodes along the blood vessels are cleared.

Preparing for surgery

Patient will receive bowel cleansing drugs day before surgery. Patient will fast overnight and surgery will be done under general anesthesia.

Recovery

Patient will be in the hospital for 5 days when done conventionally but can go home in 2 days if operated by laparoscopy. Pain can be effectively controlled by drugs and feeding can start in a day.

Will it affect fertility

Yes. Entire uterus is removed. Even the ovaries are removed during the surgery. So ability to concieve is lost. But if ovaries are retained in young patients they will continue to produce eggs and hormones delaying surgical menopause.

Early Complications

Infection, Bleeding, Deep Vien thrombosis and sometimes injury to the bowels and urinary tract structures. Because of transient injury to nerves, prolonged urinary retention and inability to void can happen.

Delayed complications

Lymphedema whereby patient will have swelling of legs which initially improves with elevation and compression stockings. Bladder disabilities can be long term also when injury to nerves is extensive.

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