Check your surgical records or ask your surgeon.
Surgical Terminology: Total vs. Subtotal Hysterectomy
In the field of gynecology and pelvic reconstructive surgery, your exact anatomy after surgery will become clear to you after knowing the surgical procedures involved. Patients in general think that a “hysterectomy” means all womb organs are removed, and they get confused after surgery about the status of the cervix, which is a part of the uterus located at the top of the vagina. Medical definition-wise, your cervix will be gone only if you had a Total Hysterectomy, while if you had a Subtotal (Supracervical) Hysterectomy, your cervix will remain there:
- Total Hysterectomy(Cervix Removed): The entire vagina including the uterus and the cervix is resected by the doctor whereas the upper part of the vagina is stitched together forming the vaginal cuff.
- Subtotal or Supracervical Hysterectomy (Cervix Retained): In such a procedure, the main body of the womb is removed above the internal os while the cervix stays in its original position in the vaginal canal.
Definitive Methods to Find Out Whether Cervix Was Removed?
If your surgical history is ambiguous, trust in your memory can be deceptive. Four clinical ways will inform you if you lost a part of the cervix:
- Your Surgeon’s Report: It’s the best legal and medically accurate way which is the surgeon’s report, so to speak. Obtain a copy of the operative report or pathology report from the hospital or clinic where your surgery has been performed. The pathology report will specifically say, in case of the specimen, if “Utterine Cervix” has been the uterine body apart.
- A Routine Gynecological Exam: During a painless gynecologic exam, your doctor will use the speculum to have a look at the uppermost part of the vagina. The presence of a cervix is easily identified by a round, smooth cervical os, which is the central hole. The absence of such a feature implies that they have found healed tissue that is known as the vaginal cuff as evidence of a removed cervix.
- Pelvic Ultrasound: With the help of an internal vaginal or pelvic ultrasound, your internal pelvic anatomy will be mapped out instantly, and it will confirm whether you still have the cervix at the very top of your vagina.
- “Mini-Periods” as a Result of Hormonal Activity: It is possible that in the case of subtotal (supracervical) hysterectomy, the ovaries still being attached, the little remains of the uterine wall lining (which might still have been retained near the base of the cervix) can generate very light, monthly spots through a normal hormonal cycle. In the case when the uterine lining bleeding was not able to happen, and the only remaining thing was the cervix, cyclical uterine bleeding is absolutely impossible.
Healing After Hysterectomy and Limitations of Activities
Besides guiding you on taking care of your personal physical condition and regular health screenings, your knowledge of the current status of your cervix is another determinant of the same. Your vaginal top relies on a newly formed vaginal cuff when a full hysterectomy was done with removal of the cervix, and the vaginal layers are gradually regenerating themselves through their own cellular closing processes. To have your pelvic floor and the vaginal cuff heal in the best possible manner structurally, you must adhere strictly to the post-operative restrictions during at least the initial recovery phase (usually 6 to 8 weeks) of your healing process. Your avoidance should be complete of any type of vaginal insertion.
In addition, no form of smoking or other tobacco products should be allowed at all for better healing results. Nicotine is a well-known, powerful systemic vasoconstrictor capable of constricting the smallest of the vessels that supply blood to the vaginal vault and as a consequence, your healing vaginal cuff gets starved of the vital oxygenated blood, which is the blood that prevents wound separation (cuff dehiscence) or delayed tissue repair.
Hysterectomy Procedure in Turkey
Going to Turkey for a consultation, treatment, and a stay of a few days is definitely among the better options. LIN Europe Clinic is an excellent choice of a medical tourism destination to address your gynae medical needs. In fact, your surgical history, anatomy after surgery, and the need for ongoing preventive health check-ups require an extremely transparent, technically advanced, and very well-organized setting that puts the safety and health of the patient first.
LIN Europe Clinic is regarded worldwide as the top one in the provision of complete medical services as well as aftercare. It is a quiet place where your health issues, especially your gynae problems, will be addressed exclusively by your doctors in strict accordance with the patient safety protocols that are recognized across the globe. By working with our team of doctors in Istanbul, you will be followed and guided by them to the best degree. Our health care is a step-by-step customized solution that fits your individual needs and helps you feel safe and supported.
By turning on the highly professional expertise of our team at LIN Europe Clinic in Istanbul, the health parameters and tests after your surgery and diagnosis will get monitored perfectly. As for us, we will be making sure that you are provided not only your body but also the state of your mind gets the utmost protection so that you can carry on with your life in a happy, clear way. It goes, indeed, smoothly when the care and attention are of the kind that you get at LIN Europe Clinic located right there in Turkey.
FAQ:
A Pathology Report or an Operative Report of the surgery are the best sources to confirm if your cervix was removed. If there is no documentation, having a pelvic examination will help the doctor to determine if your cervix is present or not immediately.
Total hysterectomy entails the removal of the entire uterus and cervix. On the contrary, subtotal (or supracervical) hysterectomy involves the removal of the main body of the uterus only, thereby leaving the cervix undisturbed at the vaginal apex.
In the case where the cervix has already been removed, and provided you never had cervical cancer and have had only low-grade abnormal cells in your report, then Pap smear may never be needed. In some cases, if a woman has a history of high-grade squamous cells, the physician might suggest having a vaginal cuff examined regularly.
Yes. The menstrual cycle might be different since some remnants of endometrial tissue may remain after surgery, but the cervix will remain in place for you to get your “period”.
When the cervix is excised during a full hysterectomy, the top portion of the vagina is sutured to close off the area and form a protective closure called a vaginal cuff.
American College of Obstetricians and Gynecologists (ACOG). (2020). Understanding Hysterectomy: Total vs. Supracervical Surgical Approaches and Cervical Retention Guidelines. Practice Bulletin No. 218.
Centers for Disease Control and Prevention (CDC). (2021). Cervical Cancer Screening Guidelines Post-Hysterectomy: Clinical Recommendations for Vaginal Vault Cytology.
Rohrich, R. J., et al. (2014). Advanced Postoperative Care, Micro-Vascular Wound Healing, and Systemic Vasoconstriction Parameters in Pelvic Tissue Recovery. Journal of Aesthetic and Reconstructive Surgery, 34(5), 587-595.
