Radical Hysterectomy: Procedure, Side Effects, & Cost


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What is radical hysterectomy?

Radical hysterectomy is an extensive surgical procedure, in which the uterus, the ligaments (tissue fibers) that hold it in place, cervix, the upper vagina around the cervix, some surrounding tissue, and the pelvic lymph nodes are removed.
In a few cases, the ovaries and fallopian tubes may also be removed depending on the patient’s condition, though removal of ovaries and fallopian tubes is not essentially a part of a radical hysterectomy.

This procedure is usually performed to treat some cancers of the cervix when other treatments such as chemotherapy and radiotherapy aren't suitable or haven't worked. Radical hysterectomy can be partially performed with the aid of a laparoscope.

Different surgical techniques or methods can be used to perform a radical hysterectomy, such as:

Depending on the patient’s condition, the particular city in India in which the surgery is being performed, the facilities available in the hospital, and the method of hysterectomy, the cost of radical hysterectomy can range between Rs. 25,000 to Rs. 2,30,000.

Laparoscopic hysterectomies are significantly more costly than abdominal hysterectomy. 

How is radical hysterectomy performed?

The following steps are involved in the supracervical/partial hysterectomy procedure:

  1. At the outset, general anesthesia is administered by an anesthetist to keep you asleep and free from pain during surgery. It is administered through an IV inserted into your vein. Either a mask is strapped to your nose and mouth or a tube is inserted into your throat to enable you to breathe easily. The tube may cause you to have a sore throat when you wake up.
  2. The next step involves the surgeon making an incision. The location and type of incision depend on the method or type of hysterectomy being performed i.e.:

  3. Using surgical instruments, the surgeon then removes the uterus, the ligaments (tissue fibers) that hold it in place, the cervix, an inch or two inches of the upper vagina around the cervix, some surrounding tissue, and the pelvic lymph nodes through the incision.
  4. Once the uterus is removed, the surgeon sutures the incision and covers it with a bandage. Bandages soaked with medicines may also be placed on your vaginal area.

Am I eligible for a radical hysterectomy?

You are eligible for a radical hysterectomy if you suffer from:

  • Cancerous tumor within the uterus
  • Large fibroid
  • Chronic and excessive bleeding (menorrhagia)
  • Uterine prolapse
  • Endometriosis
  • Adenomyosis (thickening of the uterus)
  • Chronic uterine infection
  • Severe pain associated with menopause

Please Note: Eligibility criteria for various medical procedures differs from patient to patient and depends on their general health, medical history, and medical conditions. Please consult a doctor to know more about your eligibility or ineligibility for any medical procedure. 

What risks will I face while undergoing the radical hysterectomy procedure?

The risks of undergoing radical hysterectomy include:

  • Pain
  • Infections occur in 10% of the patients.
  • Anesthesia-related problems such as rapid breathing
  • Fatigue
  • Headaches
  • Hair loss
  • Palpitations
  • Risks are higher in women who are obese or who have diabetes or high blood pressure.

What are the disadvantages of radical hysterectomy? 

The disadvantages of supracervical/partial hysterectomy include:

  • This procedure consumes more time compared to other hysterectomy procedures, however, less time than a total hysterectomy.
  • If the doctor performing the surgery is not well experienced, there is a risk of injury such as intestinal injury, urinary tract injury, ureteral injury, etc.
  • A few women may need self-catheterization if they face difficulty in passing urine, while the nerves in the tissue around the uterus are healing after surgery. If the condition continues for a few weeks after surgery, then it could be a long-term damage.
  • The procedure shortens the vagina and may cause numbness in the genital area. This may have an effect on the sexual life of the woman.

What are the complications of radical hysterectomy? 

The complications of radical hysterectomy include:

  • Injury to nearby organs.
  • Blood clots in the legs or lungs.
  • Heavy bleeding may occur in some patients
  • Pain during sexual intercourse.
  • Loss of sexual desire (conversely some women experience a drastic improvement in their sex life)
  • Vaginal dryness
  • Weight gain
  • Inadvertently created fistula during surgery, which can cause urinary incontinence or urinary leakage
  • Stress urinary incontinence

What are the side effects of undergoing a radical hysterectomy?

A few side effects of radical hysterectomy are:

  • Occasional spotting or pink discharge for up to about 6 weeks.
  • Hot flashes
  • Insomnia
  • Joint pain
  • Early menopause, if the ovaries are removed.
  • Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum.

How will I benefit from undergoing a radical hysterectomy procedure?

The benefits of radical hysterectomy include:

  • It is a lifesaver for women who have a family history of cancerous growths in their uterus.
  • It provides relief from all the symptoms a woman suffered from prior to undergoing the surgery.

What are the pre-procedure guidelines I should follow for a radical hysterectomy? 

Preparation for a radical hysterectomy typically involves several steps:

  • Physical examination to determine the overall health condition
  • Pelvic exam
  • Blood and urine tests
  • Complete medical history discussion with your surgeon
  • You may be advised to stop smoking, if you smoke, for at least 6 weeks prior to the surgery since smoking can cause problems during the operation and can also delay the healing process
  • You will be advised to not drink and eat anything at least 12 hours prior to the procedure.
  • Your doctor may prescribe an enema or a laxative to empty your bowels thoroughly before the surgery
  • The doctor may prescribe some medicines prior to the surgery, which can reduce the risk of heavy bleeding during the surgery
  • A discussion with your anesthetist regarding the anesthesia and its effects.

What are post-operative guidelines I need to follow after undergoing a radical hysterectomy procedure?

Some of the post-operative guidelines following a radical hysterectomy are:

  • Overnight stay in the hospital for 1 to 2 days. You will be monitored for discomfort and will be given medications to prevent pain and infection.
  • Post the surgery, you should avoid lifting heavy weights or any form of strenuous physical activity for at least upto 6 weeks.
  • You need to avoid tub baths for at least 6 weeks after the surgery.
  • You may have to take a liquid diet temporarily.
  • A catheter will be placed to allow the urine to drain. It will be removed the day after surgery.
  • Your incision will be covered with either surgical dressing or glue.
  • You may need to use sanitary napkins if vaginal bleeding occurs after a hysterectomy procedure and last for a few weeks.
  • After any surgery, constipation is a common problem due to the number of medicines and inactivity. Eating fruits and vegetables rich in fiber and drinking lots of fluids may help you avoid constipation. And if that is not helpful or constipation worsens, the doctor may prescribe a stool softener or a laxative.

What is the recovery period after undergoing a radical hysterectomy procedure? 

The recovery period from a radical hysterectomy procedure, depending on the patient’s condition can be anywhere between six to eight weeks.

Are the results of radical hysterectomy permanent? 

There is no definite answer to this question, as the results of the surgery can vary from person to person. Some people may experience complete relief from their symptoms, while others may suffer from side effects. It will be wise to discuss your complete medical history with the doctor, and also get to know the risks involved for you personally, before taking a decision to undergo the procedure. 

How do I know if the radical hysterectomy procedure I underwent is a success? 

Here again, the results vary from person to person. Ideally, if you are free from the earlier painful and discomforting symptoms, then quite obviously, the procedure has been a success for you. If you experience side effects after the procedure for prolonged periods, then you may need to consult with your doctor once again to understand the situation and opt for further treatments.


More Hysterectomy Related Topics 

People interested in this topic also read: 

Hysterectomy Procedures: Types, Costs, & Risks


Types of Hysterectomy


Methods/Techniques of Hysterectomy 

Related Topic

Endometriosis: Symptoms, and Treatment


In the Spotlight - Latest News on Hysterectomy

 Here are some of the latest news on hysterectomy from India and around the world:

References

1. Shazly S, Murad M, Dowdy S, Gostout B, Famuyide A. Robotic radical hysterectomy in early-stage cervical cancer: A systematic review and meta-analysis. 2018. Available at: http://www.gynecologiconcology-online.net/article/S0090-8258(15)30030-5/abstract. Accessed February 27, 2018.

2. Danesh M, Hamzehgardeshi Z, Moosazadeh M, ShabaniAsrami F. The Effect of Hysterectomy on Women's Sexual Function: a Narrative Review. 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720466/. Accessed March 1, 2018.

3. Wang X, Chen C, Liu P, Li W, Wang L, Liu Y. The morbidity of sexual dysfunction of 125 Chinese women following different types of radical hysterectomy for gynecological malignancies. 2018. Available at: https://link.springer.com/article/10.1007/s00404-017-4625-0. Accessed February 27, 2018.

Would you like to consult a doctor for Radical Hysterectomy ?

Did you know?

India's rate of hysterectomy is much lower than western countries

More than 22,000 Indian women aged between 15 and 49 out of 700,000 surveyed had undergone a hysterectomy, government data shows.

Reports of unnecessary hysterectomies in India are troubling

Women especially of poor and illiterate backgrounds are conned into surgeries mostly by quacks masquerading as doctors. Women who were seeking treatment for minor ailments were suggested hysterectomies and were also told their uterus is of use once they have babies, which is outrageously wrong and even harmful information.

Hysterectomies are mainly performed in the private sector

Two-thirds of the hysterectomies performed in India were done in the private sector and half of the women who underwent the procedure never went to school.

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