Is it essential to remove the neck of the womb at hysterectomy - Total or Sub-Total Hysterectomy?

Subtotal hysterectomy revisited.

Source:

Endoscopic Surgery and Allied Technologies. 3(2-3):105-8, 1995 Apr-Jun.

Abstract:

The advent of laparoscopic surgery has enabled gynaecologists to re-evaluate the traditional approaches to hysterectomy. Until the 1940's hysterectomy involved retaining the cervix because the simpler operation avoided damage to the ureter and prevented ascending infection, which was an important consideration before the advent of antibiotics. In order to reduce the risk of developing cervical carcinoma the cervix was traditionally removed at hysterectomy over the last 50 years. Since it is possible to remove the area where cervical carcinoma develops and with the development of an effective screening programme for cervical carcinoma, this needs no longer to be a consideration. A more logical approach to laparoscopic hysterectomy would be to retain the cervix but remove the transformation zone and in so doing there is less risk to the ureter, less postoperative urinary dysfunction, virtually no disturbance to the lower genital tract, thus resulting in little or no impairment of sexual enjoyment.

Please click on the required question.

• 1 Are heavy periods a common problem?
• 2 What is in my menstrual flow?
• 3 What range of menstrual cycle length is considered to be normal?
• 4 How can menstrual blood loss be measured?
• 5 How can I tell if my periods are abnormally heavy?
• 6 What could be the cause of my very heavy menstrual periods?
• 7 I have been sterilised. Could this be the cause of my heavy periods?
• 8 Should I have tests to find the reason for my heavy periods?
• 9 How will my heavy period problems be investigated?
• 10 What is meant by anaemia due to heavy periods?
• 11 What is intermenstrual bleeding?
• 12 What is a hysteroscopy and D and C?
• 13 What is cervical cautery?
• 14 What happens after the D and C?
• 15 What treatments are available for my heavy periods?
• 16 What are the medical treatments available for heavy periods?
• 17 How do the various medical treatments for heavy periods work?
• 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
• 19 What is a hysterectomy?
• 20 What are the indications for hysterectomy?
• 21 What are the risks (complications) of hysterectomy?
• 22 What is vault granulation?
• 23 What are the different types of hysterectomy?
• 24 Is it essential to remove the neck of the womb at hysterectomy?
• 25 Should my ovaries be removed or conserved during hysterectomy?
• 26 How long will I be in hospital when I have my hysterectomy?
• 27 I have had a hysterectomy. Do I still need to have smear tests?
• 28 What are the other surgical alternatives to hysterectomy?
• 29 How do endometrial ablation and hysterectomy compare?
• 30 Are there any psychological effects following hysterectomy?
• 31 How do we decide the best treatment for my period problems?
• 32 Could I have some recommended hysterectomy support groups?
• 33 Are there any support groups?
• Intermenstrual Bleeding - Bleeding between periods.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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