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Subtotal Hysterectomy (Partial Hysterectomy)

Surgery to remove the uterus, but not the cervix. Also called partial hysterectomy.

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(Source: NIH - National Cancer Institute)

What works? Research summarized

Evidence reviews

Heavy Menstrual Bleeding

Heavy menstrual bleeding (HMB) has an adverse effect on the quality of life of many women. It is not a problem associated with significant mortality. Many women seek help from their general practitioners and it is a common reason for referral into secondary care.

Subtotal versus total hysterectomy

When hysterectomy is required for non‐cancerous conditions, either the uterus alone (subtotal hysterectomy) or the uterus and the cervix (total hysterectomy) are removed. It has been suggested that not removing the cervix (subtotal hysterectomy) would reduce the chances of sexual difficulties or problems with passing urine or stools. This review has found no evidence of a difference between these two different operations for these outcomes. Surgery is faster with subtotal hysterectomy and there is less blood loss during or just after surgery, although these benefits are not large. With subtotal hysterectomy, women are less likely to experience fever during or just after surgery but are more likely to have long term ongoing menstrual bleeding when compared with total hysterectomy.

Hysterectomy, Endometrial Ablation and Mirena® for Heavy Menstrual Bleeding: A Systematic Review of Clinical Effectiveness and Cost-Effectiveness Analysis

The aim of this project was to determine the clinical effectiveness and cost-effectiveness of hysterectomy, first- and second-generation endometrial ablation (EA), and Mirena® (Bayer Healthcare Pharmaceuticals, Pittsburgh, PA, USA) for the treatment of heavy menstrual bleeding.

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Summaries for consumers

Subtotal versus total hysterectomy

When hysterectomy is required for non‐cancerous conditions, either the uterus alone (subtotal hysterectomy) or the uterus and the cervix (total hysterectomy) are removed. It has been suggested that not removing the cervix (subtotal hysterectomy) would reduce the chances of sexual difficulties or problems with passing urine or stools. This review has found no evidence of a difference between these two different operations for these outcomes. Surgery is faster with subtotal hysterectomy and there is less blood loss during or just after surgery, although these benefits are not large. With subtotal hysterectomy, women are less likely to experience fever during or just after surgery but are more likely to have long term ongoing menstrual bleeding when compared with total hysterectomy.

Terms to know

Abdominal Hysterectomy
Surgical removal of part or all of the uterus via an abdominal approach.
Cervix
The lower, narrow end of the uterus that forms a canal between the uterus and vagina.
Laparoscopic Surgery (Keyhole Surgery)
Surgery done with the aid of a laparoscope. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Also called laparoscopic-assisted resection.
Laparoscopy
A procedure that uses a laparoscope, inserted through the abdominal wall, to examine the inside of the abdomen. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.
Total Hysterectomy (Complete Hysterectomy)
Surgery to remove the entire uterus, including the cervix. Also called complete hysterectomy.
Uterus (Womb)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called womb.
Vaginal Hysterectomy
A surgical procedure to remove the uterine body and cervix, via the vaginal approach.

More about Subtotal Hysterectomy

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Other terms to know: See all 7
Abdominal Hysterectomy, Cervix, Laparoscopic Surgery (Keyhole Surgery)

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