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Total Hysterectomy (Complete Hysterectomy)

Surgery to remove the entire uterus, including the cervix. Also called complete 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.

Surgical approach to hysterectomy for benign gynaecological diseases

Cochrane authors evaluated which is the most effective and safe surgery for hysterectomy in women with benign gynaecological disease.

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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.

Surgical approach to hysterectomy for benign gynaecological diseases

Cochrane authors evaluated which is the most effective and safe surgery for hysterectomy in women with benign gynaecological disease.

Antibiotic prophylaxis for elective hysterectomy

Surgical operation carried out to remove the uterus (hysterectomy) is commonly performed. Most cases are performed as non‐urgent (elective) procedures for non‐cancerous (benign) conditions affecting the uterus, such as menstrual pain or abnormal bleeding patterns. Antibiotics are usually given before the operation is performed (prophylactic antibiotics, or antibiotic prophylaxis) to prevent or reduce the occurrence of infection after the procedure. Researchers in the Cochrane Collaboration reviewed the evidence on effectiveness and safety of antibiotics used to prevent infection after non‐urgent surgical operation to remove the uterus. Evidence is current to November 2016.

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Terms to know

Cervix
The lower, narrow end of the uterus that forms a canal between the uterus and vagina.
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.
Subtotal Hysterectomy (Partial Hysterectomy)
Surgery to remove the uterus, but not the cervix. Also called partial 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.

More about Total Hysterectomy

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Other terms to know: See all 4
Cervix, Laparoscopy, Subtotal Hysterectomy (Partial Hysterectomy)

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