Radical Hysterectomy

Radical hysterectomy removes the womb and cervix, nearby supporting tissues, and usually the upper vagina to treat selected pelvic cancers.

Radical hysterectomy is an operation that removes the womb and cervix together with tissues beside the cervix and a small portion of the upper vagina. The surgeon may also remove nearby lymph nodes to check whether cancer cells have spread. The ovaries and fallopian tubes may be removed or preserved depending on the diagnosis, age, tumour features, and treatment plan.

The operation can be performed through an abdominal incision or, in selected situations, using keyhole surgery. Your team chooses the approach after reviewing scans, examination findings, and the need for safe cancer surgery.

Before surgery, you may have blood tests, imaging, an anaesthetic review, and a discussion about fertility, sexual health, bladder function, and whether the ovaries should be retained. During the operation, the surgeon removes the planned tissues and may assess lymph nodes. A urinary catheter is commonly used for a short time because the operation is close to the bladder and its nerves.

Expected effects include pain, tiredness, temporary bowel changes, altered bladder emptying, vaginal discharge, and a longer recovery than a simple hysterectomy. Removing the ovaries can bring menopause symptoms. Serious problems can include bleeding, infection, blood clots, injury to the bladder or bowel, and a urinary leak. Contact your surgical team urgently for fever, worsening pain, heavy bleeding, a swollen painful leg, chest pain, or shortness of breath.

Outcomes depend on the cancer type, stage, tumour features, lymph-node findings, surgical margins, and whether additional treatment is needed. The operation aims to remove visible disease and provide tissue for accurate staging. It may control cancer in the pelvis, but no operation can promise that cancer will not return. Follow-up is used to check healing and watch for recurrence or late effects.

Radical hysterectomy causes permanent loss of the ability to carry a pregnancy. It does not always cause immediate menopause if the ovaries remain and continue working. Sexual activity can usually be discussed after healing, with timing guided by your surgeon. Ask before surgery about fertility preservation, pelvic-floor support, and help with urinary or sexual changes.

A specialist team may consider radical hysterectomy for selected early or locally contained cervical cancers and some other uterine or cervical tumours. It is not suitable for every stage or every person. Decisions may involve chemotherapy, radiotherapy, a simpler hysterectomy, or active treatment of a precancerous condition instead. Learn more about [Cervical Cancer](/conditions/cervical-cancer/), [Womb Cancer](/conditions/endometrial-cancer/), [Endometrial Hyperplasia](/conditions/endometrial-hyperplasia/), and [Uterine Sarcoma](/conditions/uterine-sarcoma/).

The usual sequence is a pre-operative assessment, admission and anaesthetic, removal of the planned organs and tissues, recovery in hospital, catheter management, and discharge instructions. Pathology examines the removed tissue. Your team then explains whether the results change the need for further treatment or surveillance.

Hospital recovery varies with the surgical approach and your health. Walking is encouraged gradually to reduce stiffness and clot risk. Fatigue may continue after the wound looks healed, and lifting, driving, work, and sexual activity each need individual clearance. Keep follow-up appointments even if you feel well, because pathology results and ongoing surveillance are part of treatment.

Ask how the planned operation may affect bladder control, bowel function, lymph drainage, menopause, fertility, and sexual wellbeing. Tell the team about medicines, allergies, previous clots, and any new bleeding symptoms such as [Bleeding Between Periods](/symptoms/bleeding-between-periods/) or [Bleeding After Menopause](/symptoms/postmenopausal-bleeding/).

Depending on the diagnosis, alternatives may include a less extensive operation, radiotherapy with or without chemotherapy, systemic treatment, or treatment directed at a precancerous change. The choice depends on tumour location, stage, fertility wishes, general health, and previous treatment.

Look for a gynaecological oncology team that can coordinate surgery, pathology, imaging, oncology review, nursing support, and rehabilitation. At consultation, ask who will perform the operation, how bladder and lymph-related effects are managed, when results will be discussed, and whom to contact after discharge.