Hysteroscopy & Cervical Stump

The debate about whether supracervical hysterectomy, when performed for benign conditions, has benefits over a total hysterectomy, remains open. There are many arguments both for and against performing a supracervical hysterectomy.

Among the different arguments presented, it is clearly demonstrated by different studies that a supracervical hysterectomy involves shorter surgical time, associated lower blood loss and faster postoperative recovery. It has also been argued that preservation of the cervical stump has positive implications in the sexual response as well as favors the support of the pelvic floor and urinary function, although the latter is yet to be confirmed.

It is clear that the main difference between one technique and the other lies in the preservation of the cervical stump and in possible problems associated with it. These include the development of cervical cancer in the remaining cervix that is estimated to occur in less than 1% of patients. The other associated problem is persistent cyclic menstrual bleeding after surgery, this happens between 0% and 25% of cases according to the different series.

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