Cervical cancer surgery can be an important part of treatment for selected patients, particularly when the cancer is confined to the cervix or nearby tissues. Like any major operation, however, cervical cancer surgery carries potential risks and complications. The likelihood and type of complications depend on the procedure performed, the extent of the cancer, the patient's overall health and whether additional treatment such as chemotherapy or radiotherapy is required.
If you are preparing for surgery, our Cervical Cancer Surgery guide provides a broader overview of the procedures, preparation, recovery and treatment considerations.
Some side effects after surgery are temporary and improve as the body heals. Others may require treatment or longer-term follow-up. Understanding these possible complications can help patients recognise warning signs and know when to contact their healthcare team.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
What Are the Risks of Cervical Cancer Surgery?
The risks vary depending on whether the patient undergoes a procedure such as conization, radical trachelectomy, hysterectomy or more extensive pelvic surgery.
Possible risks and complications include:
- Pain and discomfort
- Bleeding
- Infection
- Blood clots
- Damage to nearby organs
- Bladder problems
- Bowel problems
- Problems with wound healing
- Lymphoedema
- Lymphocysts or lymphoceles
- Fistulas
- Scar tissue
- Changes in sexual function
- Effects on fertility
- Premature menopause when the ovaries are removed or affected
Not every patient will experience these complications. The specific risks should be discussed with the surgeon before the operation.
1. Pain After Cervical Cancer Surgery
Pain or discomfort is common after surgery. The intensity usually depends on the type and extent of the procedure and the surgical approach used. Pain may occur around the abdominal or pelvic area and can be more noticeable during movement, coughing or getting out of bed during the early stages of recovery.
Doctors can prescribe pain-relieving medicines and may recommend other measures to make recovery more comfortable. Pain that becomes severe, suddenly worsens or does not improve with prescribed medication should be reported to the healthcare team.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
2. Bleeding
Some blood loss is expected during surgery. In some cases, however, significant bleeding can occur during or after the operation. Heavy internal bleeding is uncommon but can be serious. In rare circumstances, additional treatment or another operation may be required.
A blood transfusion may also be necessary if there has been substantial blood loss. Some vaginal bleeding or discharge can occur during recovery, depending on the procedure. Patients should follow their surgeon's instructions about what amount of bleeding is expected and when it should be reported.
3. Infection
Infection is a possible complication after any surgical procedure. After cervical cancer surgery, an infection can develop in the surgical wound, pelvis, urinary tract or other areas.
Possible symptoms of infection include:
- Fever or chills
- Increasing pain
- Redness or swelling around an incision
- Pus or unusual discharge from the wound
- Feeling increasingly unwell
4. Blood Clots
Surgery and reduced mobility can increase the risk of developing blood clots in the veins. A clot that forms in a deep vein is called deep vein thrombosis (DVT). A DVT may cause swelling, pain, warmth or redness, usually in one leg. In some cases, a blood clot can travel to the lungs and cause a pulmonary embolism.
Symptoms of a pulmonary embolism may include sudden shortness of breath, chest pain, coughing up blood, dizziness or feeling faint. These symptoms require urgent medical attention. To reduce the risk of blood clots, patients may be encouraged to move their legs, walk as soon as it is safe, wear compression stockings and receive blood-thinning medication when appropriate.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
5. Damage to Nearby Organs
Cervical cancer surgery takes place in the pelvis, where the reproductive organs are close to the bladder, ureters and bowel. Because of this, nearby organs can occasionally be injured during surgery.
The risk depends on the type and extent of the operation and whether the cancer has grown into surrounding tissues. If an injury occurs, the surgeon may be able to identify and repair it during the operation. In some situations, additional treatment or another procedure may be required.
6. Bladder Problems
Bladder problems can occur after pelvic surgery, particularly after more extensive procedures such as radical hysterectomy. Some patients may have difficulty emptying their bladder after surgery. A urinary catheter may therefore be left in place temporarily while normal bladder function returns.
In a small number of patients, bladder-emptying difficulties can persist for longer and require further assessment or treatment. Urinary incontinence or other changes in bladder function can also occur. The risk can depend on the extent of the surgery and the tissues or nerves affected.
7. Bowel Problems
Because the bowel is located close to the reproductive organs, pelvic surgery can sometimes affect bowel function. Patients may experience temporary changes in bowel movements, constipation, diarrhoea or abdominal discomfort during recovery. More significant bowel injury is uncommon but can occur during extensive pelvic surgery. In rare situations, an additional operation may be required to repair the bowel.
8. Wound-Healing Problems
Surgical wounds usually heal gradually after the operation. However, healing can sometimes take longer than expected. Factors that may affect wound healing include infection, nutritional problems, other health conditions, smoking and previous cancer treatment. Patients should follow the wound-care instructions provided by their healthcare team and report increasing redness, swelling, discharge or separation of the wound.
9. Lymphoedema After Cervical Cancer Surgery
Lymphoedema is swelling caused by a build-up of lymph fluid. It can occur when lymph nodes are removed or when the normal lymphatic drainage pathways are affected by treatment. After cervical cancer surgery, lymphoedema most commonly affects one or both legs, although swelling can occur in other areas. Symptoms may include:
- Swelling in one or both legs
- A feeling of heaviness or tightness
- Skin that feels tight
- Difficulty fitting into shoes or clothing
- Changes in the affected limb over time
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
10. Lymphocysts or Lymphoceles
A lymphocyst, also called a lymphocele, is a collection of lymph fluid that can develop after lymph nodes are removed. Small lymphoceles may disappear without treatment. Larger collections can sometimes cause discomfort or pressure and may need to be drained. Your doctor may use imaging to assess a suspected lymphocele and determine whether treatment is necessary.
11. Fistula
A fistula is an abnormal connection between two organs or between an organ and the skin. Although uncommon, fistulas can develop after pelvic surgery, particularly after extensive operations or when there has been damage to nearby organs.
12. Scar Tissue After Surgery
Scar tissue, also called adhesions, can form inside the abdomen or pelvis after surgery. Adhesions may cause tissues or organs to stick together. Many cause no symptoms, but in some cases they can contribute to pelvic discomfort or bowel problems. The likelihood of adhesions can vary depending on the type and extent of surgery.
13. Fertility Problems
Fertility can be affected by some types of cervical cancer surgery. A hysterectomy removes the uterus, which means the patient can no longer carry a pregnancy. Removal of both ovaries can also affect fertility and ovarian hormone production.
However, some fertility-preserving procedures may be appropriate for carefully selected patients. For example, radical trachelectomy removes the cervix while preserving the uterus, potentially allowing some patients to become pregnant in the future.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
14. Menopause and Hormonal Changes
If both ovaries are removed during surgery, or if ovarian function is significantly affected by treatment, a patient may experience menopause earlier than expected. Possible symptoms include:
- Hot flashes
- Night sweats
- Vaginal dryness
- Sleep difficulties
- Mood changes
- Reduced sexual desire
Not every cervical cancer surgery involves removal of the ovaries. Whether they can be preserved depends on factors such as the patient's age, cancer type, stage and treatment plan.
15. Sexual Health Changes
Cervical cancer surgery can affect sexual health both physically and emotionally. Some patients may experience vaginal dryness, discomfort during sex, changes in sexual desire or concerns about changes to their body after treatment.
It is also normal for emotional responses to cancer treatment to affect intimacy and sexual wellbeing. If sexual difficulties continue after recovery, patients should feel comfortable discussing them with their doctor or specialist nurse. Support and treatment options may be available.
Does the Type of Surgery Affect the Risk of Complications?
Yes. Different cervical cancer operations involve different levels of surgical complexity. For example, conization generally involves less tissue removal than radical hysterectomy, while pelvic exenteration is a much more extensive operation involving multiple pelvic organs. The risk of complications can therefore increase with the extent and complexity of surgery. Your surgeon should explain the specific risks associated with the operation recommended for you.
How Can the Risk of Complications Be Reduced?
Not every complication can be prevented, but following your surgical team's instructions can help support a safer recovery.
- Take prescribed medicines exactly as directed.
- Keep the surgical wound clean and follow wound-care instructions.
- Start gentle movement and walking when your healthcare team says it is safe.
- Follow advice about blood-thinning medication or compression stockings.
- Avoid heavy lifting and strenuous activity until you are cleared.
- Maintain adequate nutrition and hydration.
- Attend all scheduled follow-up appointments.
- Report unusual or worsening symptoms promptly.
The Bottom Line
Cervical cancer surgery can be an important part of treatment, but it carries potential risks ranging from temporary pain and infection to more significant complications such as bleeding, blood clots, injury to nearby organs, bladder or bowel problems and lymphoedema.
The risk depends largely on the type and extent of surgery. More extensive procedures, such as radical hysterectomy or pelvic exenteration, can involve greater risks because more tissues and organs are affected. Some complications can be managed effectively when identified early. Patients should therefore follow their recovery instructions carefully and contact their healthcare team if they develop unusual, severe or worsening symptoms.
Before surgery, discuss the expected benefits, possible complications, fertility implications and alternatives with your cervical cancer treatment team. Understanding the specific risks of your planned procedure can help you make informed decisions about your treatment and recovery.
