Hysterectomy for Endometrial Cancer
A hysterectomy is the surgical removal of a woman's uterus. A hysterectomy to remove endometrial cancer usually includes the removal of the ovaries and fallopian tubes (bilateral salpingo-oophorectomy). Your doctor may also do a pelvic and para-aortic lymph node biopsy to find out the stage and grade of the cancer. Most cases of endometrial cancer are diagnosed during the earliest stage, while cancer is still contained in the uterus and can be cured.
Your surgery will depend on how much of your reproductive system may be affected by endometrial cancer.
A hysterectomy for endometrial cancer may be done with an incision (cut) in the abdomen. Sometimes a laparoscopic hysterectomy is possible. In both procedures, general anesthesia usually is used. The type of hysterectomy you have depends on your medical history and general state of health and on the extent of the cancer growth. Medical centers and surgeons may prefer to do the type of surgery that they have more experience with. Pelvic and para-aortic lymph nodes will be biopsied during surgery to help find out the stage of cancer.
When done by an experienced surgeon, laparoscopic hysterectomy may have a quicker recovery and fewer complications than abdominal hysterectomy.
Some surgeons do this surgery by guiding robotic arms that hold the surgery tools. This is called robot-assisted laparoscopy.
What To Expect After Surgery
Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. Usually the stay in the recovery area is for 1 to 4 hours. You will then be moved to a hospital room. In addition to any special instructions from your doctor, your nurse will explain information to help you during your recovery.
You will likely stay in the hospital 1 to 4 days after a hysterectomy. About 4 to 6 weeks after the hysterectomy, your doctor will examine you in his or her office. You should be able to return to all of your normal activities, including having sexual intercourse, in about 6 to 8 weeks. Some light bleeding or spotting is expected for up to 6 weeks following a hysterectomy. If your vaginal bleeding is heavier or different from what you were told to expect, call your doctor.
After you have a hysterectomy, you will not be able to become pregnant.
After a hysterectomy, call your doctor if you have:
Why It Is Done
Endometrial cancer most often occurs in the inner lining of the uterus and is contained within the uterus in the earlier stages. Removal of the uterus reduces the risk of cancer recurring or spreading. The ovaries are a common site for spread (metastasis) of endometrial cancer cells and so are almost always removed at the same time.
How Well It Works
Removal of the uterus, fallopian tubes, and ovaries reduces the risk of spread or recurrence of endometrial cancer.
Most women do not have complications after a hysterectomy. But complications that may occur include:
Rare complications include:
You may have other physical problems after a hysterectomy. In some women, the pelvic muscles and ligaments that support the vagina, bladder, and rectum may become weak. The weakness may cause bladder or bowel problems, such as cystocele, urinary incontinence, or rectocele. Kegel exercises may help strengthen the pelvic muscles and ligaments. But some women need other treatments, including additional surgery.
Vaginal dryness may develop if your ovaries were removed during your hysterectomy. If sexual intercourse is painful because of vaginal dryness, use a vaginal lubricant, such as K-Y Jelly or Astroglide, or a polyunsaturated vegetable oil that does not contain preservatives. Do not use petroleum jelly (for example, Vaseline) as a lubricant, because it increases the risk of vaginal irritation and infection.
Your doctor will tell you how long you should wait after surgery before engaging in sexual intercourse. Pain during intercourse (dyspareunia) may occur if your vagina was shortened during your hysterectomy. Changing positions may help make intercourse less painful. If you continue to have difficulty with intercourse after a hysterectomy, talk with your doctor.
What To Think About
It is normal to feel a variety of emotions about having a hysterectomy. These are often based on beliefs about the importance of your uterus, fears about your health or your personal relationships, and concerns about your enjoyment of sexual activities after surgery. If you do have sexual problems after your surgery, talk with your doctor. He or she will be able to help you or direct you to a specialist who can help. To learn more, see the topic Sexual Problems in Women.
The hospital or surgery center may send you instructions on how to get ready for your surgery or a nurse may call you with instructions before your surgery.
eMedicineHealth Medical Reference from Healthwise
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