Total & Supracervical Hysterectomy (Partial Hysterectomy)

Total hysterectomy and partial hysterectomy at a glance

• The three types of hysterectomy, which is the surgical removal of a woman’s uterus, are supracervical hysterectomy, total hysterectomy and radical hysterectomy.
• Supracervical hysterectomy, also known as subtotal or partial hysterectomy, removes the upper portion of the uterus and leaves the cervix in place. This can be used to treat conditions such as endometriosis or for certain urogynecologic procedures.
• Our physicians discuss with each woman what type of hysterectomy may be best for her, depending on medical history, health conditions and her goals.
• Total hysterectomy removes all of the uterus, including the cervix. This can be used to treat many conditions, such as heavy menstrual bleeding or uterine fibroids.
• Depending on the circumstances, the surgeon may also remove the ovaries (oophorectomy) and the fallopian tubes (salpingectomy), during all types of hysterectomy.
• A radical hysterectomy, often used to treat certain cancers of the reproductive system, removes all of the uterus, cervix and surrounding tissues, including the upper part of the vagina.

What is hysterectomy?

Hysterectomy, the surgical removal of the uterus or womb, is the second most common surgery performed on women of reproductive age in the United States, second only to C-section. During a hysterectomy, the doctor may remove other organs, such as the fallopian tubes and ovaries. Removing the fallopian tubes at the time of hysterectomy, which is called opportunistic salpingectomy, can help decrease a woman’s risk of ovarian cancer.

After the uterus and other organs are removed during a hysterectomy, regardless of the type of hysterectomy, a woman will no longer have menstrual periods. She will be unable to conceive or carry a pregnancy.

Hysterectomy can be used to treat certain conditions that affect the female reproductive organs in cases where other treatments have not been successful and the woman is not interested in becoming pregnant. A doctor may recommend a hysterectomy to treat uterine fibroids, endometriosis, adenomyosis and other potential causes of pelvic pain or abnormal uterine bleeding. Hysterectomy may also be used to treat uterine prolapse and gynecologic cancers.

There are several surgical techniques that may be used to perform a hysterectomy, including minimally invasive methods such as vaginal and laparoscopic hysterectomy. Though the recommended method of surgery varies from patient to patient, minimally invasive methods are often used in place of abdominal hysterectomies, which require larger incisions and longer recovery times.

In addition to the various surgical methods available, there are also several types of hysterectomy that a doctor might recommend and perform depending on the condition that is being treated: supracervical (partial), total and radical hysterectomy.

Learn more about minimally invasive surgery at University of Colorado

Selecting a hysterectomy procedure

The type of hysterectomy performed is often dependent on a woman’s medical history, pre-existing health conditions and goals. Our doctors pair careful analysis and examination with compassion – so patients can openly discuss their needs, wants and fears and we can develop a custom surgical plan together.

What is superacervical or partial hysterectomy?

Supracervical hysterectomy, sometimes called subtotal or partial hysterectomy, is the procedure that removes the smallest amount of uterine tissue. During a partial hysterectomy, the surgeon removes the uterus but leaves the cervix in place, which is the lower part of the uterus.

Leaving the cervix in place reduces the amount of time the patient is in surgery. While it used to be thought that a supracervical hysterectomy could reduce the likelihood of sexual dysfunction, recent studies have shown that there is no difference in this between total and supracervical hysterectomies.

Supracervical hysterectomy is often used when less invasive treatments have not been successful in treating endometriosis, uterine fibroids, uterine prolapse, chronic pelvic pain, and abnormal uterine bleeding. A supracervical hysterectomy may also be preferred for certain urogynecologic procedures.

Women who have been diagnosed with reproductive cancer, or have had abnormal Pap smears in the past are not good candidates for supracervical hysterectomy. There is also a risk of continued cyclical vaginal bleeding after a supracervical hysterectomy.

Women who retain their cervix should still receive regular Pap smears, and should discuss their cervical cancer screening routine with their doctors.

What is total hysterectomy?

The most common type of hysterectomy performed is total hysterectomy, which removes the whole uterus including the cervix. The removal of the cervix is one of the greatest differences between supracervical and total hysterectomy.

Total hysterectomy can effectively treat abnormal uterine bleeding, uterine prolapse, endometriosis, chronic pelvic pain and uterine fibroids in cases where other treatment options have not been successful. It can also prevent the development of uterine cancer.

Women who have had a hysterectomy as a result of cervical cancer or cervical dysplasia (abnormal cell growth in the cervix) should discuss their post-hysterectomy cancer-screening needs with their doctor.

What is radical hysterectomy?

Radical hysterectomy is the most extensive of hysterectomy procedures and is typically performed to treat gynecologic cancers, such as cervical cancer or endometrial cancer (cancer of the uterine lining). A radical hysterectomy removes all of the uterus, the cervix, the upper portion of the vagina and surrounding tissue. This surgery is performed by a gynecologic oncologist.

Removing the ovaries and fallopian tubes (salpingo-oopherectomy)

In some situations, a doctor may recommend salpingectomy, the removal of the fallopian tubes, or salpingo-oopherectomy, the removal of one or both of the ovaries and fallopian tubes in conjunction with hysterectomy. This recommendation often depends on a woman’s medical history and the condition that the hysterectomy procedure is intended to treat.

Salpingectomy has been shown to decrease a woman’s risk of ovarian cancer. Therefore, an opportunistic salpingectomy may be recommended by her doctor.

The ovaries are responsible for producing eggs and reproductive hormones such as estrogen, progesterone and testosterone. Once the ovaries are removed (oophorectomy), women who have not yet entered menopause may begin to experience menopause symptoms such as:

• Hot flashes.
• Mood swings.
• Decreased libido.
• Vaginal dryness.
• Night sweats.

Removing both ovaries may also increase a woman’s risk of bone loss (osteoporosis), heart disease and urinary incontinence. Opting to keep the ovaries can be protective for these reasons. Women must carefully weigh the benefits and risks of keeping their ovaries, and discuss it with their doctors.

Risks of partial hysterectomy

As with all surgeries, hysterectomy procedures have possible complications. Potential complications of surgery and anesthesia that may occur in a small number of women include:

• Blood clots.
• Hemorrhage.
• Infection.
• Injury to other surrounding organs including the bladder, ureter (tube that connects the kidney to the bladder), intestines, muscles, nerves, or blood vessels.
• Formation of a fistula (an abnormal connection between the vagina and bladder).
• Allergic reactions to the anesthetic, pain medication, adhesives or skin prep used during the procedure.

While hysterectomy is considered a major surgery, complications are quite rare.