standard treatments for cervical cancer are radical hysterectomy and/or pelvic
radiotherapy. However in women that have early stage cancer of the cervix, radical
trachelectomy may be used as a fertility saving treatment. This treatment has been
developed in recent years by gynaecological oncologists in specialist centres around the
radical trachelectomy is a surgical procedure; whereby the cervix , the upper part of the
vagina, the parametrial tissue (tissue around the lower end of the uterus), and the pelvic
lymph nodes are removed. The uterus (the womb) and the ovaries are not removed and so it
is still possible to have children.
This is done in early cervical cancer; the aim
being to preserve fertility.
is done vaginally and through small incisions in the abdomen using a laparoscope, (key
who are considered for this surgery will be referred to a specialist centre; here they
will be assessed for suitability.
assessment will include:
Examination under anaesthetic
Review of pathology/biopsies performed at you local hospital.
cancer must be small and confined to the cervix.
You will be admitted to the ward the day before you are due to have surgery. You will have
the necessary tests e.g. blood test and
You will be seen by your surgeons, the anaesthetist, specialist nurse and ward nurses.
The procedure will be explained to you.
You may need a semi- pubic shave prior to surgery, the ward staff will let you know if it
You will have bowel preparation that may be two sachets of laxative that day and an enema
the morning of surgery. You can have breakfast the day before surgery, but you will be on
clear fluids, that is fluids, Jelly and Consommé for the rest of the day.
You will be in the operating theatre and recovery room for 3 4 hours.
You will spend the first night after surgery in the Critical Care Unit, as a precaution,
and then you will return to the ward the following day.
You will have a drip keeping you hydrated and this will be removed when you are drinking.
You will have antibiotics and pain- killers.
You will have a catheter in you bladder, your Surgeons will give instructions as to when
this can be removed.
You will be closely monitored, by nursing staff; who will aim to relieve any symptoms you
will be in hospital between 5 and 7 days.
You may feel weak or tired when you go home; this may persist for a few weeks. You may
feel you need to rest more than usual. Slowly increase your activity and avoid heavy
chores e.g. hoovering for first few weeks.
The Doctors or Nurses may advise you to refrain from full penetrative intercourse for up
to 6 weeks, to promote healing of the top of the vagina.
They may also suggest avoiding swimming and use of tampons for the first 6 weeks; to
prevent infection to the healing area.
You also should avoid baths for first few weeks, if this proves difficult; avoid soaking
in the bath for 6 weeks.
You may have some brown discharge from your vagina initially; if this gets heavier, foul
smelling or if you have bleeding; you should contact your specialist nurse or doctor.
- Your surgical and nursing teams will also advise you to use contraception for 6 months
after the trachelectomy.
You may return to work 4 6 weeks following surgery depending on your type of job.
On your first appointment, usually at 2 weeks you will be given the results of the
operation. The doctor will assess how you are doing and make another appointment with you.
In the next appointment you will have an examination and a smear test taken from the top
of the vagina.
In the next appointment you will have an examination, a colposcopy (microscopic
examination of the area) and a MRI.
After using contraception for the first 6 months and being assessed by the surgical team,
you can think about getting pregnant, if that is your wish.
You will be seen at your specialist centre for the first 5 years following surgery,
usually at 3 monthly periods. Then at increasing intervals.
you discover that you are pregnant, you will need to contact you GP; who needs to refer
you to a hospital with high- risk obstetrics and neo-natal facilities.
are delivered by caesarean section at 38 weeks.
can get more information on the statistics of children born to women following
trachelectomy from your surgeon or nurse specialist.