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Hysterectomy, Cervix, and Pelvic Organ Support

From the Pre-Op Hysterectomy Articles List

Hysterectomy and Cervix and Pelvic FloorI have heard that keeping the cervix is best for pelvic organ support. Is this true?

There is a lot of controversy surrounding supracervical (or partial) hysterectomy versus complete (or total) hysterectomy. Prior to the 1950s, most hysterectomies were supracervical. The trend then changed to total hysterectomies. Today, retaining the cervix is once again in vogue. Yet, studies are mixed regarding whether or not there are benefits for keeping the cervix. Both physicians and women with strong opinions remain steadfast on each side of the topic.

When making decisions regarding the cervix, remember that it is not a separate organ; it is the bottom portion of the uterus. To remove only the upper portion of the uterus, the surgeon cuts the cervix from the rest of the organ. Thus, more than simply the desire to keep the cervix may play a part in hysterectomy type. The diagnosis leading to a hysterectomy and/or your physical situation could dictate that the cervix be removed with the rest of the uterus.

When considering prolapse implications, the topic is still not black and white. To date, there have been no published studies that indicate retaining the cervix will aid in post-hysterectomy pelvic support. There are a wide variety of risk factors that can lead to pelvic organ prolapse (POP), and the cervix itself can prolapse. Any pelvic surgery, including a partial or complete hysterectomy, can create a prolapse risk. As such, most surgeons generally use procedures to carefully tack everything in place and strengthen the pelvic floor during the hysterectomy operation. Other prolapse risk factors include obesity, smoking, genetics, hormone issues, vaginal births, and heavy lifting. If you have more than one risk factor, you could be more likely to have prolapse whether or not you retain your cervix.

When there is the option of retaining the cervical portion of the uterus, personal choice and physician experience may play the biggest roles in the decision process. There could be advantages in both the surgery and recovery process of the supracervical hysterectomy option, but so far no data suggests definite prolapse prevention benefits when retaining the cervix.

Talk to your surgeon about your thoughts regarding the cervix. Also, seek a second opinion about which choice is best for you.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

07-10-2013 - 01:17 PM


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