Myth about Cervical Stump after Supracervical Hysterectomy
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Myth about Cervical Stump after Supracervical Hysterectomy
Myth about Cervical Stump after Supracervical Hysterectomy
Many gynecologists favor to perform supracervical hysterectomy instead of total hysterectomy when performed for benign conditions. Arguments used in favor of such recommendation are that it entails less operating time, less blood loss and faster patient’s postoperative recovery. Other arguments are that preserving the cervix has positive impact on the sexual life of the patient as well as better support of the pelvic floor and urinary function. These last arguments seem not to be supported by solid research evidence. There are in fact several problems that may arise related to preserving the cervical stump after performing a subtotal hysterectomy.

These complications include cervical stump prolapse, chronic pelvic pain, the development of cervical or endometrial carcinoma, necrosis of the stump and cyclic recurrent vaginal bleeding. In regards to cyclic bleeding, its incidence varies between different studies between 0% and 25%, the bleeding is due to the presence of an excessive amount of residual endometrium at the level of the cervical stump. Although electrocoagulation of the cervical canal is routinely done at the time of a supracervical hysterectomy, it has not been shown that this practice significantly reduces the incidence of persistent cyclical bleeding. 

A supracervical hysterectomy is a surgical procedure that removes the uterus, but leaves the cervix intact. It is often done to treat conditions like fibroids, endometriosis, or abnormal uterine bleeding. However, there is a common myth surrounding this procedure that says leaving the cervix in place can lead to the development of a cervical stump. In this essay, we will explore the truth behind this myth and why it persists.

What is a cervical stump?

Before we delve into the myth, it is important to understand what a cervical stump is. A cervical stump is a small piece of the cervix that remains after a hysterectomy. It is sometimes left behind intentionally if the surgeon wants to preserve some of the cervix, or it can be left accidentally if the surgeon does not remove all of it.

The cervical stump is not a medical problem in and of itself. In fact, many women who have had a hysterectomy with a cervical stump have no problems at all. However, in some cases, a cervical stump can cause complications.

Myth: Leaving the cervix intact leads to the development of a cervical stump

The myth that leaving the cervix intact leads to the development of a cervical stump is not entirely true. A cervical stump can develop after any type of hysterectomy, regardless of whether the cervix is left intact or not.

When a hysterectomy is performed, the cervix is either removed or left in place. If it is left in place, the cervix is typically cut away from the uterus and the blood vessels and ligaments that attach it to the body are sealed off. This leaves a small portion of the cervix, known as the cervical stump.

The development of a cervical stump has nothing to do with whether the cervix is left intact or not. Rather, it is a result of how the hysterectomy is performed. If the surgeon fails to remove the entire cervix, then a cervical stump can develop. This can happen whether the cervix is left intact or not.

Complications of a cervical stump

While a cervical stump is not a problem in and of itself, it can cause complications in some cases. The most common complication is vaginal bleeding. This can occur if the cervical stump is not properly sealed off during the surgery. If the stump is left open, it can bleed and cause vaginal discharge.

Another potential complication is the development of cervical cancer. While leaving the cervix intact does not increase the risk of cervical cancer, a cervical stump can sometimes become cancerous. This is more likely to happen if the patient has a history of abnormal cervical cells or human papillomavirus (HPV) infection.

Treatment of a cervical stump

If a cervical stump is causing problems, it can be treated. The most common treatment is a procedure called a cervical stump removal. This involves removing the remaining portion of the cervix. This can be done vaginally or abdominally, depending on the size and location of the stump.

In some cases, a cervical stump removal may not be necessary. If the patient is not experiencing any symptoms, the stump can be left in place and monitored for changes.
 

Why does the myth persist?

Despite the fact that leaving the cervix intact does not increase the risk of developing a cervical stump, the myth persists. One reason for this is that there is a lack of understanding about the procedure among the general public. Many women who have had a hysterectomy may not fully understand what the procedure involves, which can lead to confusion and misinformation.

Another reason for the persistence of the myth is that some healthcare providers may perpetuate it. In some cases, healthcare providers may recommend removing the cervix in order to prevent the development of a cervical stump, even though this is not necessary. This can perpetuate the myth that leaving the cervix intact is risky.

It is important for healthcare providers to educate their patients about the risks and benefits of different types of hysterectomy procedures, including the decision to leave the cervix intact or not. This can help to dispel myths and ensure that patients are making informed decisions about their health.

Conclusion

In conclusion, the myth that leaving the cervix intact leads to the development of a cervical stump is not true. A cervical stump can develop after any type of hysterectomy, regardless of whether the cervix is left intact or not. While a cervical stump is not a problem in and of itself, it can cause complications in some cases. If a cervical stump is causing problems, it can be treated with a cervical stump removal. It is important for healthcare providers to educate their patients about the risks and benefits of different types of hysterectomy procedures to dispel myths and ensure that patients are making informed decisions about their health.

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