Supracervical hysterectomy: back to the future?

Supracervical hysterectomy, commonly performed in the earlier decades of this century, is rarely performed in contemporary practice. The desire to prevent future cervical cancer initially underlay the advocacy of total hysterectomy. Cervical cytologic screening and effective outpatient treatment of preinvasive cervical disease are commonly available. Cancer of the cervical stump is an uncommon and largely preventable occurrence. Removal of the normal cervix reportedly may have adverse effects on bladder, bowel, and sexual function. Reduced operating time and a shorter recovery period may be associated with a supracervical procedure. The risk of subsequent cervical cancer may not outweigh the benefits of supracervical hysterectomy, which should be offered as an option to selected patients. Supracervical hysterectomy by minilaparotomy is within the capability of practicing gynecologists and may be adaptable to outpatient short-stay surgery, offering a cost-effective alternative for a variety of gynecologic conditions.