Subtotal hysterectomy and myomectomy - Vaginally

Supracervical hysterectomy - the vaginal route.

“…Nevertheless, an interesting review by Thomas and Magos was published in 2011 [2]. The authors described briefly the surgical technique used in their hospital, concluding that the vaginal route for STH is easy to learn and definitely worth wider application.…”

“…Using clamps or sutures, a bite was taken into the uterus. Simultaneous downward traction and taking other bites as high as possible allowed the uterus to be delivered into the vagina [2]. …”

“…The patient should be informed that in some cases it is not possible to obtain amenorrhea after the procedure. Gynecologists ought to remember that hormonal therapy should consist of estrogen opposed with progestogen to reduce the risk of endometrial cancer [2]. …”

“…There are three main approaches to this intervention: abdominal, vaginal and laparoscopic [1]. The procedure can be performed in two ways: by removing the whole uterus including the cervix (total hysterectomy – TH) or excising only the body of the uterus and leaving the cervix intact (subtotal, also known as supracervical hysterectomy – STH) [2]. The first operation of total transabdominal hysterectomy was successfully performed in 1929 [3].…”

“…For about 30 years now surgeons have discussed the potential predominance of STH over TH with regard to sexual, urinary and bowel function and pelvic organ prolapse. However, it seems that the most important factor to be taken into consideration when deciding whether the cervix should be removed is patient preference [2]. …”