Supracervical Hysterectomy versus Total Abdominal Hysterectomy, Benefits and Risks

With so many hysterectomies performed each year, researchers are looking to learn more about which procedures are more effective and less life altering. In terms of major surgery performed, hysterectomy is second only to cesarean delivery among reproductive-age women. Most often, this second most popular practice is used to treat abnormal bleeding associated with the uterus and also to treat gynecological cancers

A supracervical hysterectomy (SCH) involves a technique that removes the uterus but, unlike the total abdominal hysterectomy (TAH), does not remove or damage the cervix. Instead the cervix is left intact. According to a statement from the American College of Obstetricians and Gynecologists (ACOG), this technique should not be viewed as more effective or more desirable than the traditional procedure, which removes the uterus and cervix.

The ACOG also concluded that the supracervical hysterectomy put woman at a greater risk for future problems that might require more surgery and in turn more risk.

One recent study concluded that patients who had a TAH had less sexual intercourse, fewer orgasms and less sexual satisfaction than patients who underwent the SCH. The question of interest is what accounts for this difference?

Research from the 1960s put forth the idea that the cervix played a role in female sexual response. Based on this theory, it would make sense that sexual enjoyment would be greater when the cervix was left intact, as with SCH.

Along the same lines, another study indicated that the stimulation of nerve endings of the cervical plexus play a large part in a woman’s ability to reach orgasm. Removal of the cervix results in the loss of a significant portion of the plexus, and a loss of sensation.

There are conflicting reports and data on the benefits of SCH verse TAH, and the verdict is still out as to which is a better option in general.