Does supracervical hysterectomy provide more support to the vaginal apex than total abdominal hysterectomy?
OBJECTIVE
The objective of the study was to assess whether cervical preservation at the time of hysterectomy may help prevent subsequent apical vaginal vault prolapse.


METHODS
Supracervical hysterectomies were performed in 12 unembalmed cadavers. Successive hanging weights of 1, 2, 3, and 4 kg were loaded against the cervical stump and distances moved were recorded. The same process was repeated after completion of a total hysterectomy.


RESULTS
Average distances pulled with 1, 2, 3, and 4 kg of traction against the cervical stump were 17.8 +/- 1.9, 24.1 +/- 2.5, 29.0 +/- 2.8, and 34.3 +/- 3.5 mm, respectively. After total hysterectomy, these distances were 17.5 +/- 2.5, 23.5 +/- 2.6, 29.3 +/- 3.1, and 34.5 +/- 3.6 mm, respectively.


CONCLUSIONS
In unembalmed cadavers, it appears that total abdominal hysterectomy and supracervical hysterectomy provide equal resistance to forces applied to the vaginal apex.
Rahn
David D
DD
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
Marker
Allison C
AC
Corton
Marlene M
MM
Roshanravan
Shayzreen M
SM
McIntire
Donald D
DD
Schaffer
Joseph I
JI
Wai
Clifford Y
CY
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002584:Cervix Uteri / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D014596:Uterine Prolapse / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D014621:Vagina / Q000503:physiopathology* / Q000601:surgery