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No. 238-Supracervical Hysterectomy.

Sari Kives1, Guylaine Lefebvre1

  • 1Toronto, ON.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|June 21, 2018
PubMed
Summary

Vaginal hysterectomy (VH) and supracervical hysterectomy (SCH) may offer benefits over total abdominal hysterectomy (TAH) regarding sexual and urinary function, and complications. This guideline focuses on evidence for these surgical options.

Keywords:
Hysterectomyperioperative complicationspostoperative complicationssupracervicalvaginal

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Area of Science:

  • Gynecology
  • Surgical Outcomes

Background:

  • Hysterectomy is a common procedure for benign gynecological conditions.
  • Surgical approach (vaginal, abdominal, or supracervical) can impact patient outcomes.
  • Evidence comparing different hysterectomy techniques regarding functional and complication outcomes is crucial for informed patient choice.

Purpose of the Study:

  • To review evidence comparing vaginal hysterectomy (VH) and supracervical hysterectomy (SCH) with total abdominal hysterectomy (TAH).
  • To assess the impact of these procedures on postoperative sexual function, urinary function, and peri- and postoperative complications.
  • To provide guidance for women considering hysterectomy for benign conditions.

Main Methods:

  • Systematic literature search of Cochrane Library, Medline, and Embase (1950-2008).
  • Inclusion of systematic reviews, RCTs/CCTs, and observational studies comparing VH/SCH with TAH.
  • Evidence quality rated using Canadian Task Force criteria; grey literature also reviewed.

Main Results:

  • Evidence suggests potential differences in sexual and urinary function outcomes between VH/SCH and TAH.
  • Peri- and postoperative complication rates may also vary depending on the surgical approach.
  • The guideline focuses on comparing these specific hysterectomy methods, excluding laparoscopic approaches.

Conclusions:

  • Women undergoing hysterectomy for benign disease have options regarding cervix preservation (SCH) or removal (VH, TAH).
  • The choice between VH, SCH, and TAH should consider potential impacts on sexual and urinary function, alongside complication risks.
  • This review provides a basis for discussing surgical options and patient preferences.