What is a partial hysterectomy? Differences, benefits and risk factors

“Partial hysterectomy” is one of those phrases that isn’t very specific. It’s not always clear what the term means. So, most doctors try to avoid using it. 

But when people speak of a partial hysterectomy, the scientific term for what they’re describing is usually a supracervical hysterectomy. That’s a procedure in which the bulk of the uterus is surgically removed, but the cervix is left behind.

So, why might you need this type of procedure? How will it affect your menstrual cycle? And will you still be able to conceive or carry a child naturally after having one?

Here’s what I tell my patients about partial — or supracervical — hysterectomies.

How does a partial hysterectomy differ from a “full,” “complete” or “radical” hysterectomy? 

• A partial or supracervical hysterectomy removes the bulk of the uterus but leaves the cervix intact.
• A full or complete hysterectomy removes the uterus and the cervix.
• A radical hysterectomy removes the uterus, cervix and upper vagina, as well as some of the tissue surrounding the cervix.

But removal of the ovaries and fallopian tubes is considered a separate surgery. I feel like it’s important to mention that here. Because sometimes, people mistakenly think all the other pelvic organs are removed during a hysterectomy, too. They are not.

When is a partial hysterectomy necessary in cancer treatment?

A partial hysterectomy is used quite rarely in cancer treatment. Any surgical treatment related to endometrial cancer is going to call for a full hysterectomy.

But we do have some data indicating it can be safe for certain patients with ovarian cancer if removing their cervix would increase the risk of prolapse, bladder injury or other complications. 

Are there any other types of cancer that partial hysterectomies can treat?

The only other one I can think of would be peritoneal cancer, under certain circumstances. But it wouldn’t be safe to leave any uterine tissue behind if someone has endometrial cancer. So, those situations would require a total hysterectomy.

Are there any other non-cancerous reasons to have a partial hysterectomy?

Yes. Partial hysterectomies are often used to treat uterine fibroids, or leiomyoma.  

What are the benefits of a partial hysterectomy?

There’s the potential for better sexual function, if you retain the cervix. In theory, that’s because it doesn’t disrupt as many of the nerves and ligaments as a full hysterectomy. But that’s still a somewhat controversial topic.

The other possible benefit is avoiding complications like prolapse and incontinence. If I’m performing surgery on someone with ovarian cancer, for instance, and they’ve got a lot of scar tissue around their cervix, I might opt to leave it alone, because I don’t want them to have any issues with their bladder.

What are the risks of a partial hysterectomy?

If cancer is present in the uterus or cervix, we could potentially leave it behind if we don’t remove the entire organ. That’s why we don’t typically recommend this procedure.

What happens to the other reproductive structures after a partial hysterectomy? 

The ovaries and fallopian tubes are still attached to the abdominal walls by other ligaments. So, they don’t need any additional securing. But when we sew the vagina back together, we usually attach it to the uterosacral ligament to make sure it stays in the proper position.