Yes, cervix removal is common in total hysterectomy.
The Prevalence of Total Hysterectomy in Modern Gynecology
Gynecology and pelvic reconstructive surgery are two surgical disciplines that, in addition to clinical skills, heavily rely on an understanding of standard surgical methods and procedures in the field. One of the major points of concern that patients raise when considering uterus removal is whether the surgeons must remove the cervix along with the body of the uterus. From a purely medical viewpoint, yes, the practice of removing the cervix together with other parts of the uterus during a normal hysterectomy is very popular in modern medical practice, especially total hysterectomy, in which both the body (fundus) of the uterus and the cervix are taken out, has become the standard method that is practiced most in the medical field. It constitutes the largest segment of all surgeries that involve the removal of reproductive organs. Leaving the cervix in place is the exception, which is the case only for particular anatomical or surgical conditions.
Clinical Advantages of Removing the Cervix
Surgical removal of the cervix along with the rest of the uterus by surgeons is usually due to several long-term health and lifestyle factors:
- Total risk removal for cervical cancer may be the single most powerful reason for a patient to elect removal of the cervix. By removing the cervical tissue, the patient is no longer subject to regular Pap smears and HPV testing and therefore will be totally free of worry that any of these tests might indicate something wrong.
- In your case, where only a subtotal hysterectomy is done with preservation of the ovaries, there may be a few remnants of endometrial lining situated close to the top part of the residual cervix that react to your cyclic hormone levels and thus can lead to constant, light menstruation-type bleeding (“mini-periods”). The removal of the cervix would prevent such post-hysterectomy bleeding situations.
- Getting rid of cervical conditions is another reason. Having a normal cervix, you are still at risk of developing benign cervical problems later. A common example is chronic cervicitis, and other cervical growths such as polyps and fibroids, which may have to be removed through a complicated secondary operation at a much later stage.
Circumstances Where the Cervix Is Retained
In spite of the fact that removing the cervix is almost always the main decision, there are indeed certain situations that a surgeon may point out which are so special or unique that retaining of the cervix might be considered a wise alternative:
- Severe Pelvic Adhesions/Endometriosis: In very rare cases, when a woman with a history of many abdominal operations develops adhesions, or she has had a bad case of PID and/or developed a big chunk of deep infiltrating endometriosis around the bladder or bowel, detachment of cervix can be dangerous because there is risk of damage to nearby ureters or gut, and leaving the cervix is a safer option.
- Shorter Surgical Duration: Leaving the cervix reduces the number of steps of the operation and thus helps surgeons to save time while performing the surgery and also blood loss that may happen during the surgical procedure, particularly when patients are having emergency surgery or have a condition that increases their vulnerability.
- Personal Patient Preference: Some people prefer keeping the cervix for reasons such as pelvic floor stability or sexual response, which, however, are quite subjective. In this case, even though it is medically understood that women do not differ in levels of sexual satisfaction or pelvic organ prolapse between total and subtotal hysterectomies, these factors have been cited as personal reasons for some women wanting to keep their cervix intact.
Post-Surgical Healing and Kinetic Boundaries
This is a period after surgery, especially after a total hysterectomy, when patients who are really devoted to getting their body perfectly healed are supposed to adhere very strictly to a behavioral rule that would help keep their tissues under repair in tip-top condition. After removing the cervix by a total hysterectomy, the surgeon closes the upper part of the vaginal canal by sewing together an artificial closure made out of the patient’s native tissue. In the very beginning, from 6 to 8 weeks, this closure is held together only by microscopic threads that surgeons use to suture tissues and the very early-stage cells of fibrin that are present only after surgery.
Suddenly, the increase in abdominal pressure and rubbing of the top of the woman’s private parts can have really serious biological consequences. Indeed, such activities might result in the tearing of healing tissues followed by the occurrence of a quite serious vaginal cuff dehiscence, in other words, the separation of the wounds. To have your genital structure stabilized in a precise way you need to be very strict with these forbidden things: do not allow any vaginal penetration (which could be from a partner, tampon, or douching), and do not perform activities that could result in pressure on the lower abdomen, such as heavy lifting, vigorous exercise, or very strong straining, during this time that you were told by your clinical team.
Hysterectomy in Turkey
LIN Europe Clinic is an exceptional choice if one decides to get themselves checked up or treated; the facility is a combination of clinical prowess, technical know-how, and human kindness to the patient. The choice we make at a certain level of medical precision and the protection we provide the patient after the surgery, these are two different things, yet the success rate of both in the case of the removal of the body of uterus (with and without cervix), the post-surgery care for the tissues of the pelvic area, and the support to the patient during the recovery phase is an outcome of very professional and well-structured medical system.
We are aware as a healthcare center that after undergoing hysterectomy (which can be done either through removal of only the body of the uterus or, in the extreme case, where also the cervix gets removed), one’s medical journey does not end at that stage of the removal of the organs. On the contrary, it only takes off from there so that after-surgical tissue repair and life integration can begin. It requires a sophisticated setting where information sharing, understanding, and decision-making are very clear, and the whole process is very straightforward- a kind of support that is so highly empathetic that at its core it leaves no room for misunderstanding.
FAQ:
Indeed, it is the standard and most common practice. Most of the total number of hysterectomies done on the globe today involve total hysterectomies (removal of both uterus and cervix) which account for the largest majority.
Eliminating risk of cervical cancer 100% is the major advantage. It also stops the possibility of small monthly bleeding (“mini-periods”) and removes the chance of developing benign cervical polyps/fibroids at a future time.
A very skillful surgeon, when removing the cervix, would not cause the vaginal length to decrease noticeably. The top of the vagina is carefully reshaped by the surgeon into a new safe area called the vaginal cuff.
Removing the cervix requires the pelvic ligaments that previously supported it to be reattached to the vaginal cuff. It keeps anatomical strength intact preventing prolapse in the long run.
In case your cervix is removed and also you have no history of having very pre-cancerous cervical cells (CIN 2/3), or you did not have cervical cancer previously, you can normally discontinue getting your Pap smears completely on a routine basis.
American College of Obstetricians and Gynecologists (ACOG). (2020). Total vs. Supracervical Hysterectomy: Clinical Indications, Cervical Retention Standards, and Outcomes. Practice Bulletin No. 218.
DeLancey, J. O. (1992). Anatomic aspects of vaginal eversion after hysterectomy: Managing uterosacral ligament suspension vectors and cervical removal dynamics. American Journal of Obstetrics and Gynecology, 166(6), 1717-1724.
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.
