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Hi, I've never used this site before so I'm not sure who will acknowledge. I'm wondering why do doctors remove the cervix even though there is not a situation involving cancer. Will this cause problems down the line? I've only found an area that speaks of weakening the pelvic floor. Any thoughts? Thanks
You have brought up a very controversial issue. The cervix and uterus are actually one organ, therefore some drs remove the entire organ as there is not a "perfect" way to know where to cut the uterus that would allow leaving the portion called the cervix, with no uterus attached, to prevent future cramps, or uterine issues.
Also, there are other issues for which you might wish to have your cervix removed. Mine was removed due to endo. Some have to have it removed because of prolapse issues. And depending on which surgery type is best for you, your cervix may have to be removed for that hyst type.
Additionally, some women keep their ovaries, so if they keep their cervix, there is potential for having a mini period and some women would rather not deal with this possiblity.
Also, not all women have pelvic floor issues just because they have their cervix removed. I am over 5 yrs post hyst and I have had no problems with not having my cervix. Some pelvic floor issues are actually more related to hormone deficiency which can allow the ligaments that hold everything up in the pelvis to relax and stretch - they lose their tone.
I hope this information helps! You can also search for more information in our resource database, the tab is to the left of your screen. To find other threads about the cervix, use the search tab to the top, right of your screen. Best wishes to you!
Surgeons began removing the cervix in the 1950s, after antibiotics became effective (before that, all hysterectomies retained the cervix, because the risk of infection is much less with the cervix intact.) With antiobiotics, infection rates decreased, so taking out the cervix became an option. This was before the PAP smear was invented, and cervical cancer was a major killer, so removing the cervix seemed worthwhile to reduce cervical cancer risk. Now, however, with the pap smear, the risk of cervical cancer is very low if a woman has had years of clear pap smears.
The pro's of cervix removal: no chance of a mini-period. For women with a history of abnormal pap smears or a family history of cervical cancer, lower cervical cancer risk
The con's of cervix removal: the operation is much more complicated, and even with antiobiotics, it takes longer, requires longer in the hospital, has a longer recovery time, and has higher infection and complication rates. Retaining the cervix may, for some women, increase ligament strength and sexual response; for other women, it may not make a difference. Most American surgeons are trained in removing the cervix, so that's what they're used to doing. European surgeons have mostly switched over to keeping the cervix. It's a simpler surgery. I chose to keep my cervix, mostly because of the infection and recovery rate studies, and my recovery has been very easy and rapid, so I'm happy with the choice.
I had my TAH a month ago and doc took my my cervix with my uterus. I asked her at my pre-op if my cervix was to be removed and she said it was. Since its considered an entire unit its easier. My ovaries were left in but the tubes were taken, they had cysts. My hospital stay was only 2 days, I haven't had any problems (thank God) with my cuff or anything. No bleeding since right after surgery, not even any spotting. I consider myself lucky and blessed. Now, I haven't been cleared for sex so I can't answer to whether or not it will affect my sex life. I'd like to think that it won't.
I'm just glad there won't be any mini-periods, no periods at all. I love it. My only problem right now is hotflashes and nightsweats. Gotta love it huh.
(((here we go))) As (((Weiser))) mentioned, whether or not the cervix should be removed during a hysterectomy is a very controversial issue. There are women (and DRs) who feel very strongly that the cervix should be kept unless it must be removed because of cancer; there are women (and DRs) who feel very strongly that it's not a good idea to keep the cervix; and there are opinions everywhere in between.
The reason for the hysterectomy has a lot to do with what type of surgery is done and whether or not the cervix is kept. For example, I had my hyst vaginally for severe prolapse. There was no way I could keep my cervix -- it was already outside my body before the surgery started. And women with cancer generally must have the cervix removed along with the uterus (and often ovaries too) because, as already mentioned, there is no line that tells the DR where the cervix begins and uterus ends; the cervix is part of the uterus. Most women with endo and/or adeno have their cervix removed with the uterus because if they don't, it's likely that they will continue to experience problems. Fibroids can also grow on the cervical stump, though they don't always.
Some DRs say that the cervix helps preserve sexual functioning. However, we did a survey a while back in the Sexual Dysfunction forum here; as many ladies with as without cervixes were having problems. Sexual functioning (including libido and lubrication) have much more to do with ovarian function (or the ability to compensate with HRT's) than with whether or not we have a cervix. There are women who, before surgery, enjoy the feeling of their partner 'bumping' the cervix during intercourse, and do miss that feeling if the cervix is removed; however, there seem to be more women who find that sensation painful and are glad not to have it anymore.
Some DRs claim that the cervix helps with pelvic support. Well... mine sure didn't. In fact, if the DR does a good job of reattaching the ligaments that were attached to the uterus (including cervix) to the vaginal vault after surgery, pelvic support should be as good or better as before. What makes more of a difference is, again, hormones. Low hormone levels, whether it be due to having the ovaries removed and not using HRT's (or not enough HRT), or due to natural menopause if the ovaries are kept, can contribute to a weakening of the pelvic floor, cervix or no cervix. Other factors that can contribute are: heredity (weak pelvic floor ligaments tend to run in families); weight (obesity is a major risk factor for prolapse); prior vaginal deliveries, especially of larger babies; lifting, pushing or pulling heavy weights; and chronic constipation (puts a surprising amount of stress on the pelvic floor).
I found this in our Resources directory:
In fact, symptoms related to the cervical stump requiring further surgery frequently occur following a laparoscopic supracervical hysterectomy. Twenty-five percent of the patients continued to menstruate, and 10% had symptoms of discharge. Careful long-term analysis of results demonstrates a high complication rate reporting symptoms related to the cervical stump in 24% of patients, all requiring further operations. Adhesions, especially between the bowel and the cervical stump, endometriotic lesions, cervical pathologies ( chronic cervicitis, SIL, mucocoeles), myomas and prolapse have been reported at long-term follow-ups.
While the discomfort and recovery time may be a little less for ladies who keep their cervix, the complication rate for supracervical hysts (especially laparascopic) is, in fact, higher than for total hysts -- especially when you add in the likelihood of further trouble with the cervix requiring more surgery.
As I mentioned before, my hyst was done vaginally, so I did not keep my cervix. I've done just fine without it. I still have regular (annual) vaginal vault smears -- same as PAP smears only there is no cervix to swab, so the sample is taken from the vaginal cuff area. I have more than adequate lubrication, my response is better than pre hyst (and has gotten better with time and hormonal balance), and my pelvic support, which was abysmal pre-op, is just fine. However, my prior history of prolapse makes me extra-vigilant about making sure I get enough estrogen vaginally, get my weight down and avoid constipation and heavy lifting.
I hope this helps. You see, there are as many opinions on this issue as there are members here!
You've got a lot of infomation here already. I would just add that some of use don't have a choice even without the cancer issue (your original question) - mine had endometriosis on it so had to come out too.
I haven't noticed any difference with intercourse although as mentioned, some women do. I have been very good at doing all the suggested pelvic floor exercises- not sure if it makes a difference but I'm not taking any chances!
Mine, (cervix) was enormous... so it was removed.. I don't know anything else as of yet... haha, no help, sorry... but I have read up on weakening the pelvic floor,. I don't think we have anything to worry about that. just my unending support!
I love your posts surferbabe. You are very informed and informative and you explain everything in a way that I can understand. I had a supracervical abdominal hysterectomy. Does this type of surgery also have higher rates of complication or is it just the laprascopic? I was given the choice of whether or not to keep my cervix and I felt that it was better to keep it if I could. So far I have not had any problems nor miniperiods, and I want to make sure and do everthing I can to prevent furthur problems.