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Wednesday, September 2, 2015

Subtotal Hysterectomies May INCREASE Incontinence Rates

All decisions with hysterectomy have risks and benefits. For some women there are over-riding reasons to have a subtotal hysterectomy. For others the decision to keep your cervix may be based on personal preference rather than scientific fact. Hysterectomy means removal of the uterus, so if you have had a removal of the uterus, but your cervix was conserved, this is called a subtotal hysterectomy. The term partial hysterectomy is not a clinical term used by gynos although women may refer to hysterectomy without taking the ovaries as a partial hysterectomy and it really doesn't refer to the taking of the uterus. In a study published in the June issue of the American Journal of Obstetrics and Gynecology showed that in fact there was no improvement in incontinence rates if the cervix was left, and preliminary studies show that the rates of incontinence could actually increase if a subtotal hysterectomy rather than a complete hysterectomy were to be performed.

Other considerations for your health if you have had cervical conservation are to be discussed with your gyno. She will likely tell you this will not impact your sexual pleasure as orgasms are from the clitoral area, and not the cervix. If you keep a cervix at the time of the hysterectomy you still need pap smears according to the plan established by your gyno. But a woman with no cervix after a hysterectomy is not routinely (excluding those with cancers and precancers) recommended to have a pap smear in any of the current guidelines. This includes the organizations: ACS, ACOG, USPSTF, ASC, ASCCP just to name a few. Don't confuse pelvic examinations with pap smears. Pelvic examinations can determine the health of your vagina, the health of your vulva, the health of your urethra, feel your inner organs, and determine your pelvic floor muscle health, just to name a few of the benefits.

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