Trachelectomy

The cost of a trachelectomy with Circle Health Group depends on a variety of factors, including the type of surgery you have and where you have it. Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it.

Fixed-price packages

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Spread the cost of your payment

Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

Private health insurance

If you have private health insurance, your treatment will usually be covered by your provider. Speak to your insurer directly to find out more information on this.

If you have any questions about our fixed-price packages and flexible payment options, you can speak to a friendly member of our advisory team on 0141 300 5009

Your cervix - the lower part of your uterus (known as the 'neck' of your womb) - is covered with a layer of skin-like cells on its outer surface (your ectocervix). When these cells grow in an uncontrolled way over time, they will eventually form a mass of tissue that becomes a growth (or tumour). A tumour can be either benign (non-cancerous) or malignant (cancerous) A cancerous tumour may spread to other areas of our body (known as metastasising) and can be life-threatening.

If your cervical cancer spreads, it can reach your lymph nodes, which are responsible for protecting your body against infections, as well as filtering, draining, and circulating the tissue fluid that bathes your cells and tissues. As a result, a radial trachelectomy may also involve your surgeon removing the lymph nodes around your womb and cervix.

Early cervical cancers and pre-cancerous cell changes usually don't cause any symptoms, which is why it's important that you have regular cervical screenings with us. Some signs that you may have cervical cancer include:

• Bleeding from your vagina
• Pain or discomfort during sex
• Vaginal discharge
• Pain in your pelvis (the area between your hip bones)

Please note that there are many other conditions that cause these symptoms - most of which are more common and less serious than cervical cancer.

There are some risk factors that can increase the likelihood of you developing cervical cancer, such as:

HPV infection

More than 95% of cases of cervical cancer are due to human papillomavirus (HPV). This is an extremely common viral infection of your reproductive tract that generally doesn't have any symptoms. In most cases, HPV infections clear up on their own, without you even realising you had the condition, but there is a chance that it becomes chronic and leads to pre-cancerous lesions that eventually progress into invasive cervical cancer.

Sexual history

Becoming sexually active at a young age (younger than 18 years old) or having many sexual partners increases your chances of being exposed to HPV, which in turn means you are more susceptible to developing cervical cancer.

Smoking

If you smoke, you are about twice as likely to develop cervical cancer compared to those who don't smoke. The harmful substances found in tobacco can be absorbed through your lungs and carried in your bloodstream, potentially causing damage to the DNA of your cervical cells, which may in turn lead to cervical cancer.

Weakened immune system

Any condition that weakens your immune system, such as HIV (human immunodeficiency virus), puts you at a greater risk of developing an HPV infection, along with diminishing your body's ability to destroy cancer cells and slowing their capacity for spreading. Pre-cancerous cell changes in your cervix can morph into an invasive malignant cancer faster than it normally would if you have a weakened immune system.

Having chlamydia

It has been shown that you are at a higher risk of cervical cancer if blood tests show evidence of a past or current chlamydia infection. Chlamydia bacteria can also help HPV grow and live on your cervix, increasing your chances of having cervical cancer.

Frequent and/or early pregnancies

If you have had three or more full-term pregnancies, there is a higher risk of you developing cervical cancer. This is due to being more susceptible to HPV infection and subsequent cancer growth. In addition, you are also more likely to be a candidate for cervical cancer if you had your first full-term pregnancy before the age of 20.

Family history

Cervical cancer may run in your family. If your mother or sister had (or has) cervical cancer, your chances of developing the condition are higher than if nobody in your family had it. This may be due to an inherited condition that makes you less unable to fight off HPV infection than others.

Your consultant will ask you some questions about your condition. These include what symptoms you have, when they show up, how long they've been going on for, whether anything makes them better or worse, along with your general health and any other medical conditions you have.

They will most likely do a physical examination as well. This will involve you lying on a treatment table with your knees up and legs apart. Your consultant will place a speculum (a smooth tube-shaped tool) into your vagina, which keeps your walls open and allows them to look at your cervix and check for any abnormalities. They may also take a swab to check for any infections, such as chlamydia.

Your consultant might also do a pelvic examination, known as an internal. This involves inserting gloved fingers into your vagina, along with pressing a hand on your belly, to feel your pelvic organs and check for any lumps and/or tender areas.

Please note that you are free to ask for a female consultant. You can also have a family member, friend, or partner present as well if that makes you feel more comfortable.

Tests

To confirm that you have cervical cancer, along with determining the size of any growths that may have developed in your cervix and deciding on the right treatment for you, your consultant may do a series of tests. These include:

Screening (smear test)

Known as a smear test, cervical screening is done to check the health of your cervix. This not a test for cancer. It is performed to see if you have HPV and is recommended for all women aged between 25 and 64. The smear test involves inserting a soft brush through a speculum to your cervix, which is then rotated to collect a sample that will be sent to our lab for testing.

Colposcopy

This is a test that enables your consultant to look at your cervix in greater detail. They do this with a colposcope, which is a large magnifying glass that they use to look closely at the skin-like covering of your cervix (your ectocervix). Using this device means they can see changes that might be too small to see with their naked eye.

LLETZ

If screening has shown that you have abnormal cervical cells, your consultant may recommend LLETZ treatment. This stands for large loop excision of the transformation zone and involves using a thin wire loop to remove the transformation zone of your cervix, located near its opening. The wire has an electrical current that runs through it and cuts the tissue, sealing the wound at the same time. This treatment may mean that you don't require a simple or radical trachelectomy.

Cone biopsy

In cases where you have symptoms that could be caused by cervical cancer, your consultant may suggest you have a cone biopsy. This procedure is done under general anaesthetic, which means you’ll be asleep and won't feel anything. A cone shaped wedge of tissue from your cervix will be removed and sent to a laboratory, which allows your consultant to confirm if cancerous cells have developed in your cervix and formed a growth.

If your tests show that you have stage one cervical cancer, meaning the cancer is only in your cervix, your consultant will recommend a radical trachelectomy. They will speak to you about what you can do to prepare for your surgery.

Plan for a hospital stay

You'll need to stay in hospital for three to five days after your trachelectomy procedure. This is so we can give you pain relief and check on how you've responded to the treatment. So, before coming to the hospital, think about packing a small suitcase of provisions that will make your stay with us more comfortable, such as loose-fitting clothing and a tablet/laptop to keep yourself entertained.

Tests

Your consultant may ask to do a few tests to check if you're able to go under general anaesthetic. These may include:

• Blood tests
• ECG (to confirm that your heart is healthy)
• Breathing tests
• Chest X-ray to see if your lungs are in a healthy condition

Make your home recovery friendly

Think about how you can make your home as recovery friendly as possible. For example, set up your recovery space on the ground floor if this applies to you, as this will mean you avoid tripping or falling down the stairs. Make sure you have everything you need within easy reach so that you can focus on resting. You should also take a moment to consider any potential tripping hazards in your home (loose flooring, furniture, general mess, etc) and make sure they have been dealt with ahead of your visit to hospital.

Stock up on supplies

For the first couple of weeks after your radical trachelectomy, you'll need to rest as much as possible and avoid any unnecessary movement, which means you won't be able to make quick trips to the shop. Ahead of coming to hospital, be sure to round up all the supplies you might need so that you can rest easy after your procedure. If you can, have a family member, partner, or friend nearby during this time to pick up additional supplies whenever they're needed.

Check your medications

Your consultant will speak to you about any medications that you are taking before arranging your trachelectomy procedure. If you are on aspirin, warfarin, anti-inflammatories, or some other blood-thinning medication, they may ask that you stop taking these before your surgery to prevent any unwanted bleeding both during and after the procedure.

Stop smoking

As a smoker, there is a higher risk of you having breathing or heart problems both during and after your trachelectomy. It means you'll need more general anaesthetic, which can lead to other complications. Continuing to smoke after your surgery also may affect the extent to which you recover. Your consultant may as a result ask that you stop smoking for at least a week prior to your visit to hospital.

Food and drink

Eat a healthy balanced diet before your procedure, and drink plenty of water as well. If you are obese, the chances of complications during surgery are higher, and your consultant may as a result give you some safe ways to lose weight.

Avoid alcohol for 48 hours prior to your treatment. As is always the case before a surgery with general anaesthetic, don't drink or eat anything after midnight on the day of your procedure - apart from small sips of water.

This surgery is performed under general anaesthetic, which means you'll be asleep for the entire procedure and won't feel any discomfort. Your trachelectomy will follow these steps:

• Once you are asleep, a breathing tube is placed through your mouth and into your windpipe to help you breathe during the surgery. A urinary catheter (a flexible tube) will also be used to empty the bladder and collect urine in a drainage bag
• Your surgeon will make an incision, or several small incisions, in your stomach area, allowing them to examine your lymph nodes with a narrow telescope known as a laparoscope
• If they find that your cervical cancer has spread to your lymph nodes, they will remove a portion of your lymph modes and send them to a pathologist to be tested. If there isn't any cancer outside your cervix, they will simply continue with your radical trachelectomy. Your abdominal incision(s) will then be sutured (the stitches dissolve a few weeks after your procedure)
• A small incision will then be made at the top of your vagina, with your surgeon then using special surgical instruments to remove your cervix, which then passes through your vagina to leave the body
• The top two to three centimetres of your vagina and the tissue from around your cervix will also be removed to ensure that no cancerous tissue is left behind
• Your consultant will then put a tight stitch where your cervix was, leaving a small opening for blood flow during your period. This stitch is there to reduce your chances of miscarriages or having your baby prematurely
• The remaining portion of your vagina will then be attached to the remaining part of your cervix and uterus
• Your consultant will then close up your incision, and you'll be transferred to a post-operation recovery room

You should make a full recovery from your radical trachelectomy in around six weeks. Everyone's recovery timeline is slightly different, however, and the speed at which you get back to normal activities can be influenced by a range of factors, such as:

• Your fitness levels
• Your everyday activities
• The nature of your job
• Your general health
• Your age

Recovering in hospital

When you wake up from surgery, you may feel a bit groggy. This is a normal side effect of going under general anaesthetic, and it'll wear off in a few hours. If you are in pain, your nurse will provide you with pain relief medication to make sure you're comfortable. There may be a drip attached to your hand to give you fluids after you wake up, along with a catheter being inserted into your bladder to drain your urine.

Your catheter will need to stay in for around 10 days, as having it in place helps your cervical area to recover and heal. You shall be discharged from the hospital after three to five days with your catheter attached to a bag on your leg, and your nurse will teach you how to care for your catheter. There is a chance you'll have some vaginal bleeding for the first few days following surgery, which usually turns into a red/brownish discharge before going away. This may go on for a few days or a few weeks.

One to two weeks after your trachelectomy

When you get home from hospital, you'll probably feel some pain at the site of your incisions, and we'll make sure you have all the pain relief medication you need. There is a chance that you'll have some constipation after your surgery, in which case we'll also provide some laxatives for you. Your consultant will check on how you're recovering when you come in to have your catheter removed 10 days after your trachelectomy.

During this period, you'll need to rest and avoid any physically strenuous activities, while also doing some gentle activity, such as short walks or sitting exercises prescribed by your physiotherapist. This can help to reduce the chances of blood clots and chest infections, along with increasing your energy levels.

Two to six weeks after your trachelectomy

If your job doesn't involve standing, walking, or any other kind of physical activity, such as a desk job, you may be able to return to work after four weeks. This timeframe will be much longer if you do a job that involves manual labour. It may be two to three months before you can return to full activities. Please speak to your consultant about when it's safe for you to return to work.

You should be able to start driving again four to six weeks after your radical trachelectomy. It will be around six weeks before you can have sex again, as this generally how long it takes for the area to completely heal. You may feel like you need to take a bit longer before you're ready to have sex again.

Your consultant will arrange an appointment to discuss your results. If they show that your cervical cancer cells have been successfully removed, you usually won't need any further treatment. You will need to have follow-up appointments every six months for the first two years after your radical trachelectomy to make sure that you have made a full recovery and your cervical cancer has not come back.

Complications can sometimes occur with a radical trachelectomy, but these are extremely rare. Your consultant will take you through all the potential risks before choosing a date for your procedure.

General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of a trachelectomy

• Increased chance of miscarriage, premature birth, troubles getting pregnant, or high-risk pregnancy
• Damage to your surrounding organs
• Bowel obstructions
• Hernia (when one of your organs pushes through an opening in the muscle or tissue that normally holds it in place)
• Vaginal discharge
• Pain during sex
• Difficulty peeing or being unable to control your peeing
• Painful or irregular periods
• Numb thigh
• Lymphedema (when fluid builds up in your limbs)
• The outer part of your vagina swells up

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to suit your routine
• The freedom to choose which hospital and consultant best fit your needs
• Personalised, consultant-led treatment plans tailored to your individual requirements
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about the trachelectomy procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in January 2023. Next review due January 2026.

1. Radical trachelectomy for the treatment of early-stage cervical cancer: a systematic review, NIH
2. Cervical cancer, Cancer.org
3. Cervical cancer, Cancer Research UK
4. Radical cervical trachelectomy, Onco Link
5. Radical trachelectomy, MSKCC
6. Radical trachelectomy, NHS Trust