Does supracervical hysterectomy provide more support to the vaginal apex than total abdominal hysterectomy?

Am J Obstet Gynecol. 2007 Dec;197(6):650.e1-4. doi: 10.1016/j.ajog.2007.08.050.

Abstract

Objective: The objective of the study was to assess whether cervical preservation at the time of hysterectomy may help prevent subsequent apical vaginal vault prolapse.

Study design: Supracervical hysterectomies were performed in 12 unembalmed cadavers. Successive hanging weights of 1, 2, 3, and 4 kg were loaded against the cervical stump and distances moved were recorded. The same process was repeated after completion of a total hysterectomy.

Results: Average distances pulled with 1, 2, 3, and 4 kg of traction against the cervical stump were 17.8 +/- 1.9, 24.1 +/- 2.5, 29.0 +/- 2.8, and 34.3 +/- 3.5 mm, respectively. After total hysterectomy, these distances were 17.5 +/- 2.5, 23.5 +/- 2.6, 29.3 +/- 3.1, and 34.5 +/- 3.6 mm, respectively.

Conclusion: In unembalmed cadavers, it appears that total abdominal hysterectomy and supracervical hysterectomy provide equal resistance to forces applied to the vaginal apex.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomechanical Phenomena
  • Cadaver
  • Cervix Uteri / physiopathology*
  • Cervix Uteri / surgery
  • Female
  • Humans
  • Hysterectomy* / adverse effects
  • Hysterectomy* / methods
  • Middle Aged
  • Uterine Prolapse / etiology
  • Uterine Prolapse / physiopathology*
  • Uterine Prolapse / prevention & control
  • Vagina / physiopathology*
  • Vagina / surgery