Radical Hysterectomy Cancer Care

Risk Factors

Risk factors for gynecological cancer requiring radical hysterectomy:

• HPV infection (high-risk subtypes 16 and 18)
• Multiple sexual partners or early sexual activity
• Smoking and chronic immunosuppression
• Obesity and hormonal imbalances
• Family history of gynecological cancers

Who is at Risk

Women with cervical cancer, early-stage uterine cancer, or recurrent gynecological malignancy who meet surgical criteria are candidates for radical hysterectomy. Fitness for major surgery and cancer staging determine candidacy.

Diagnosis

Pre-surgical workup includes:

• MRI pelvis and abdomen for staging
• CT chest and abdomen for metastasis evaluation
• PET scan for high-risk cases
• Colposcopy and cervical biopsy for cervical cancer
• Endometrial biopsy for uterine cancer
• Cystoscopy or sigmoidoscopy if local spread is suspected

Treatment Options

Radical hysterectomy can be performed as open surgery, laparoscopic, or robotic-assisted procedure. It is combined with pelvic lymph node dissection and sometimes para-aortic lymphadenectomy. Adjuvant radiation or chemotherapy may follow based on final pathology.

The Procedure

The surgical procedure involves:

• General anesthesia and pre-operative preparation
• Open or laparoscopic/robotic surgical access to the pelvis
• Dissection and removal of uterus, cervix, upper vagina, and parametria
• Bilateral pelvic lymph node dissection
• Para-aortic node sampling in indicated cases
• Nerve-sparing technique to preserve bladder and bowel function
• Closure with drain placement and post-operative monitoring

After the Surgery

Post-operative care includes:

• Hospital stay of 3 to 5 days
• Catheter for 7 to 14 days for bladder recovery
• Pain management and early mobilization
• Awaiting final pathology for adjuvant therapy decisions
• Pelvic floor physiotherapy
• Regular oncology follow-up every 3 to 6 months

Possible Complications of Radical Hysterectomy

Potential complications include:

• Bladder dysfunction or urinary retention
• Lymphedema of the lower limbs
• Bowel or ureteral injury
• Vaginal shortening affecting sexual function
• Lymphocele formation
• Premature menopause in premenopausal women