Hysterectomy, which is the surgical removal of a woman’s uterus can be of several different types, depending upon what reproductive organs are removed and which are preserved. A radical hysterectomy is one type of this surgery where not only the uterus but also the cervix, lymph nodes, parametrium and upper vagina are surgically removed. The ovaries and fallopian tubes are also usually removed in the radical procedure.
When a radical hysterectomy may be indicated
Hysterectomy is a controversial subject with many experts opining that a majority of hysterectomies in the developed world are performed needlessly. They are generally not indicated for benign conditions and certainly not before all other options have been tried.
This surgical procedure is indicated for gynecological cancers such as cervical cancer. When it is cancer, there is usually no option other than surgery. However is not indicated for any other conditions except as a last resort when everything else has been tried and was found to fail.
Whether or not the ovaries will also be removed during a hysterectomy, depends upon several factors such as a woman’s age, whether she is menopausal or not, and how the surgery could affect sexual function.
What are the side effects of a radical hysterectomy?
Since the cervix and an inch or two of the deep vagina are also removed, many women may have fears about sexual dysfunction post the surgery. However when the uterus and cervix are removed, the top of the vagina is stitched up to form a closed tube. Some women do find that the vagina becomes rather shallow after the procedure.
A radical hysterectomy will typically not impact a woman’s experience of sexual pleasure or sensitivity; in fact it could take care of problematic symptoms such as painful sex or bleeding during sex. However reaching orgasm could be problematic after the procedure. The removal of the uterus though could make some women feel somewhat diminished to begin with and it could take time to reconcile to the idea.
There could also be pain and lack of interest in sex following a radical hysterectomy; however, many of these problems resolve about 6 to 24 months after the surgery.
When the ovaries are removed, the woman may find herself undergoing sudden and in cases severe menopause. Even in cases where the ovaries are spared, to prevent the sudden onset of menopause, some women find that menopause like symptoms could occur. This is called unintended premature ovarian failure. It is thought to occur since the blood supply to the ovaries may be disrupted and the endocrine feedback to the ovaries may be missing. In cases benign cysts also form in the ovaries after the procedure.
Incontinence is another possible consequence of this type of hysterectomy but it could begin many years after surgery. Vaginal prolapsed also is likelier after this type of hysterectomy than it would be otherwise.
Other than these specific side effects of a radical hysterectomy, there are also the other risks that any type of surgery carries: risk of bleeding, accidental injury during the surgery, infection, long recovery time and so on.