Problems after cervical cancer surgery

There is a risk of problems or complications after any operation.

Possible problems after cervical cancer surgery include damage to organs or swelling in one or both legs (lymphoedema). Other risks include infection, blood clots and bleeding.

Many problems are minor, but some can be life threatening. Treating them as soon as possible is important.

Infections

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. You will have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of infection.

They include:

• a high temperature
• shivering
• feeling hot and cold
• feeling generally unwell
• cough
• feeling sick
• swelling or redness around your wound and your wound might feel hot
• a strong smell or liquid oozing from your wound
• loss of appetite

Rarely for an infection in your wound, you may need another operation.

Vaginal bleeding

You may have some vaginal bleeding after a trachelectomy or hysterectomy. It can be similar to a light period. It usually changes to a red or brown discharge before stopping. The discharge can last for a few days to a few weeks. 

Tell your doctor or nurse if the:

• bleeding starts again after stopping
• bleeding becomes heavier
• discharge is green or yellow, or smells

Some women have irregular or painful periods after a trachelectomy. Occasionally, the entrance to the womb becomes too tight, meaning the blood from a period can't escape. You might need a minor operation to open up the entrance again. Tell your doctor if your periods don't return to normal after the trachelectomy.

Bleeding in your pelvis or abdomen

You'll have some blood loss during your operation. Sometimes you may need a blood transfusion for this.

There is a small risk of internal bleeding after the operation. This is rare. If this happens you may need a second operation.

Your nurse will check you regularly after surgery for signs of blood loss.

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.

It's important to continue wearing compression stockings if you have been told to by your doctor.

Damage to other organs in the pelvis or abdomen

Any surgery to the pelvis or abdomen risks damaging parts of the body that aren't being removed. This includes organs such as the:

• bladder
• tubes that take urine to the bladder (the ureters)
• bowel

Your surgeon usually notices if a problem develops during the operation and can repair it. Occasionally, you may need a second operation.

Problems with healing

Your wound might heal slower than expected. This might be due to infection or because of the cancer treatments you’ve had in the past.

Fluid leaking in the abdomen

Rarely, after a pelvic exenteration, fluid may leak from the area where the surgeon has joined two tissues (anastomosis). This can happen when, for example, two pieces of bowel are joined together. You may:

• feel unwell
• have a high temperature
• have severe pain in your abdomen

You may need:

• antibiotics
• fluids through a drip
• a drain to get rid of the fluid
• a second operation to repair the leak

Fistula

A fistula means an opening. After an operation, an abnormal connection or path can develop between two body areas. Depending on where in the body it is, this means fluid may flow to another area of the body. For example, if one develops in the bladder, urine can leak out to another part of the body.

After pelvic exenteration, there is a risk of developing a fistula in your pelvis or abdomen, such as from your bladder or part of the bowel.

To get rid of the fistula, your doctor may put in a tube to drain it. You also have medicines to control any swelling (inflammation). The tube stays in until the fistula dries up. The fistula may then heal on its own. Sometimes, you may need another operation to repair the fistula.

Scar tissue in the pelvis or abdomen

After any surgery to your pelvis or abdomen scar tissue (adhesions) can develop. This usually doesn’t cause any problems.

But scar tissue can sometimes cause pain, or part of your bowel may stick together and cause a blockage (obstruction). You might need an operation for this.

Numbness at the top of legs

There are nerves in the pelvis that are very close to where you have surgery. Some of the nerves may be damaged during the operation. This can cause numbness or tingling at the top of your legs or inside your thighs. This normally gets better in 6 to 12 months.

Swelling in your legs (lymphoedema)

If you have lymph nodes taken away as part of your operation, the flow of lymphatic fluid around your body can be disrupted. In some women, the fluid may build up in one or both legs, or rarely in the genital area.

This swelling is called lymphoedema. It can develop any time after surgery for the rest of your life. Your nurse will give you information about how to reduce the risk of this happening.

Tell your nurse or doctor if you notice any swelling.

Bladder or bowel problems

After any surgery to the pelvis or abdomen, there is a risk of damaging the:

• bladder
• tubes that take urine to the bladder (the ureters)
• bowel

Your gynaecological oncologist usually notices if a problem develops during the operation and can repair it. Occasionally, you may need a second operation.

A small number of women have problems emptying their bladder after having a radical trachelectomy or hysterectomy. If this happens, you may need to go home with a tube to drain the urine from the bladder (a catheter) for several weeks. Rarely, you may have long term difficulties emptying your bladder.

A lump or cyst in your abdomen (lymphocyst)

A lymphocyst or lymphocele is a collection of lymph fluid. It can develop in your tummy (abdomen) after the operation. The fluid often goes away by itself. But if the lymphoceles are large or causing pain, your doctor may drain them with a needle.