Having your operation for womb cancer

Before your operation, your surgeon will need to be sure you are fit enough to make a good recovery. You may have had some of these general tests when your cancer was being diagnosed. If so, you may not need to have them again. You are most likely to be asked to have these tests in the outpatient department. But some hospitals do them when you come into hospital the day before your operation. You will probably have

• Blood tests to check your general health and kidney function
• A chest X-ray to check your lungs are healthy
• An ECG to check your heart is healthy
• CT scan or MRI scan

The scans are done so that your specialist can see how far the cancer has grown. You may also have

• Breathing tests (called lung function tests)
• To learn breathing and leg exercises

Your nurse or a physiotherapist will teach breathing and leg exercises to you. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are advised you need to.

Breathing exercises will help to stop you getting a chest infection. And leg exercises will help to stop clots forming in your legs. These can happen when you are not moving around as much as you normally would. So your nurses will encourage you to get up and about as soon as possible after your operation. But you have had major surgery, and you may need to stay in bed for the first couple of days.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)

When you go into hospital for your operation, the anaesthetist and probably one of the junior doctors working for your surgeon will see you. The doctors should give you a detailed explanation of what to expect and how you will feel when you come around after the anaesthetic has worn off. Do ask as many questions as you need to. It may help to make a list of your questions before you go into hospital for your operation. They will ask you to sign a consent form for the operation.

There are some suggestions for questions at the end of this section. Many people find that the more they know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses. Some people prefer not to know much about what is going to happen so don't want to ask questions and that is fine.

You may have a drip (intravenous infusion) put into your arm before your surgery so that you can be given fluids. This makes sure you are not dehydrated before your operation. But if you have been eating and drinking normally, this may not be needed.

Your nurse may shave your pubic hair to make sure the operation site is as clean as possible. This reduces the risk of an infection getting into your wound. You may have this done on the ward. Or you may have a shave in the operating theatre after you have had your anaesthetic.

We have more information about what happens before your operation.

When you wake up, you will have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You may have

• Drips (intravenous infusions) to give you fluids until you are eating and drinking again
• One or more fine tubes (wound drains) coming out near your wound to drain away fluid that collects and so help your wound heal
• A tube down your nose into your stomach (nasogastric tube) to drain it and stop you feeling sick
• A tube into your bladder (catheter)

You will not be able to eat or drink at first. But as soon as you are fully awake you will be able to wet your mouth with sips of water. Your doctor or nurse will listen to your abdomen (tummy) with a stethoscope to see if your bowel is working properly – often it stops for a while after abdominal surgery. But you will probably be eating and drinking normally again within a couple of days at the most.

You may have a blood pressure cuff on your arm when you first wake up. A small clip on your finger may measure your pulse (called a pulse oximeter) and check your oxygen levels. You may also have an oxygen mask on for a while. You'll have your blood pressure taken quite often for the first few hours after you come round from the anaesthetic. Your urine output may also be checked because it can help to show whether you are having too much fluid or are getting dehydrated.

You may have a couple of electric pumps attached to your drips. These control any medicines you are having through the drip, so it goes in at a steady rate.

If you have had a big operation you may wake up in intensive care or a high dependency recovery unit. This is nothing to worry about. These are places where you can have one to one nursing care. As soon as your doctors are sure you are recovering well, you will move back to the ward.

We have more information about what to expect immediately after your operation.

You may have some pain for the first week or so. It is important to tell your doctor or nurse as soon as you feel any pain. Pain can usually be well controlled but they may need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly, so it is important to take them as your nurse or doctor advise.

When you first wake up, you may have a pump containing painkillers attached to your drip. You may have a hand control from the pump with a button to press to give yourself extra painkillers, as you need them. This is called patient controlled analgesia (PCA). Do use it whenever you need to. You can’t overdose because the machine is set to prevent that. If you need to press the button very often let your nurse know. They can arrange for you to have a higher dose of painkiller in the pump.

Some hospitals use painkillers through a drip into your spine for the first day or so after surgery. This is called an epidural and usually works very well. You may come back from theatre with the epidural already set up. You'll have a very fine tube taped to your back. This connects to a pump, which gives you a continuous dose of painkiller into the space around your spinal cord.

You are most likely to have a wound that runs vertically, up and down your lower abdomen. This is called a mid line incision. It allows the surgeon good access to all parts of the abdomen so your surgeon can check the tissues around the womb thoroughly. Or you may have a wound that runs across your lower abdomen, from right to left. This is called a transverse incision. If you are overweight, this may be easier for the surgeon and will heal more easily.

If you are having surgery for stage 1 womb cancer you may have keyhole surgery. You may have about 3 or 4 small wounds where the surgery instruments and camera were put in.

The wound or incision sites from the operation will be covered up when you come round. They may be left covered for a couple of days. Then your nurse will change the dressings and clean the wound or incision sites. The wound drains will stay in until they stop draining fluid. Your nurse will change the bottles attached to them every day. Wound drains can usually come out about 2 to 7 days after your operation.

Your stitches or clips will stay in for at least 7 to 10 days. Usually, your nurse will take them out before you go home. But if they are still in, you can either have an appointment to go back and have them taken out at the hospital, or a district nurse can come to your home to remove them.

For the first few days after surgery getting up and moving around may seem impossible. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit every day after your operation to help with your breathing and leg exercises.

Your nurses will encourage you to get out of bed and sit in a chair one or two days after your surgery. They will help you with all the drips and drains. Over the next couple of days, the tubes, bottles and bags will start to be taken out. Then it will be much easier to get around and you should begin to feel that you are making progress.

You will need to rest for at least a month when you go home after this type of abdominal (tummy) surgery. Your first outpatient appointment is usually arranged for about 6 weeks after the date of your surgery. Until this time, you will be advised not to

• Do heavy housework, such as vacuuming
• Carry heavy bags of shopping or washing
• Drive

This is because all these activities put pressure on your abdominal muscles and skin. The skin has been cut during your surgery and stitched back together. It needs time to heal and it will take longer to get over your operation if you put too much strain on the area. You will gradually be able to increase the amount you can do. A short walk every day is a good idea. You will get a bit of fresh air, and you can gradually go further as you get your strength back. Do take it easy at first though – remember that however far you walk, you have to cover the same distance to get back home.