Should I Keep My Cervix when I Have My Hysterectomy?

It can be difficult to decide if you should keep your cervix or not when having a hysterectomy. Each woman has unique needs and there are many questions about the cervix that need answered when making your decision.

By definition, the cervix is part of the uterus. Removing the top of the uterus and leaving the cervix (the lower part of the uterus) may be an option for some women. This is then called a Partial, Supracervical, or Subtotal Hysterectomy.

This option is definitely a topic that must be discussed with your doctor who knows your medical history.

If your cervix is healthy, and you have no history of bad pap smears, you are most likely a candidate for keeping your cervix.

Some believe that the cervix helps to provide pelvic floor support for the bladder (incontinence) and lower abdominal area with the hope of relieving possible vaginal prolapse issues.

Some also believe that retaining the cervix helps with sexual health by keeping nerve endings in the cervix and lower uterus that may be the involved with orgasmic responses. Some women like the feeling of bumping when the cervix is left.

Pap smears are still necessary after your hysterectomy along with your regular gynecological checkups.

On the downside, some HysterSisters who keep their cervix report possible mini-periods from the endometrium (uterine lining) still attached to the cervix even if the surgeon cauterized it during surgery. A “mini-period” can mean anything from slightly discolored spotting to light bleeding. Ovaries or cyclic hormones must be present to cause the small amount of endometrium to cycle and bleed. The majority of women don’t have mini-periods. If you have your ovaries removed and are using estrogen replacement, you may want to consider using some progesterone to avoid endometrium proliferation.

Also on the negative side is the possibility that the cervix will have to be removed in another surgery. reports more than one woman who retained her cervix only to develop cervical cancerafter her surgery. A history of bad paps or HPV is a good reason not to keep your cervix.

Retaining your cervix helps with an easier, quicker recovery because there is no vaginal cuff (stitched-closed top of the vagina) to heal. The cervix leaves a more natural closure to the vagina. Years ago, before antibiotics, the cervix was routinely retained as a natural closure to the outside. The risk for post-op infection may be reduced.

Deciding to have a hysterectomy can be a difficult question by itself. It is important to explore all your options (Keep ovaries? Keep cervix? Abdominal surgery? Laparoscopic surgery? Vaginal surgery? Robot assisted surgery)? Talk over all your concerns with your surgeon, consider a second opinion, and do the best you can with the information you have and recommendations of your physician.

This content was written by staff of by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support. Reprinted with permission: Should I Keep My Cervix when I Have My Hysterectomy?


Recent Posts