The debate about whether supracervical hysterectomy, when performed for benign
conditions, has benefits over a total hysterectomy, remains open. There are many
arguments both for and against performing a supracervical hysterectomy.
Among the different arguments presented, it is clearly demonstrated by different
studies that a supracervical hysterectomy involves shorter surgical time, associated
lower blood loss and faster postoperative recovery. It has also been argued that
preservation of the cervical stump has positive implications in the sexual response as
well as favors the support of the pelvic floor and urinary function, although the latter is
yet to be confirmed.
It is clear that the main difference between one technique and the other lies in the
preservation of the cervical stump and in possible problems associated with it. These
include the development of cervical cancer in the remaining cervix that is estimated to
occur in less than 1% of patients. The other associated problem is persistent cyclic
menstrual bleeding after surgery, this happens between 0% and 25% of cases
according to the different series.