What is Supracervical Hysterectomy

A supracervical hysterectomy (also called subtotal hysterectomy) is a surgery to remove the top part of the uterus while leaving the cervix in place. It may be done to treat these problems:

• Fibroid tumors.
• Endometriosis.
• Certain types of uterine cancer.

This surgery is usually done using a technique called laparoscopy. The technique is minimally invasive, which means that it is done through small incisions instead of a large incision. The result is less pain, lower risk of infection, and shorter recovery time.

The surgery is sometimes done with a procedure to remove the fallopian tubes and ovaries (bilateral salpingo-oophorectomy). After the surgery, menstrual periods will stop and it will no longer be possible to get pregnant.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Blood clots in the legs or lung.
• Infection.
• Changing from small incisions to open abdominal surgery.
• Additional surgery later to remove the cervix, if you have problems with the cervix.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicine

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.
• To reduce your risk for infection, you may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• You will be given an antibiotic medicine.
• A gas will be used to inflate your abdomen. It will allow your surgeon to look inside your abdomen and perform the surgery.
• Three or four small incisions will be made in your abdomen. One of these incisions will be made in the area of your belly button.
• A thin, flexible tube with a light and camera (laparoscope) will be inserted into an incision. The camera on the laparoscope will send pictures to a TV screen in the operating room, making it easy for the surgeon to have a good view of your abdomen.
• Surgical instruments will be inserted through the other incisions.
• The uterus will be cut into small pieces and removed through the incisions.
• Your incisions will be closed with stitches (sutures) or steri-strips

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You may have some discomfort, tenderness, swelling, and bruising at the surgical site.
• You will be given pain medicine for use in the hospital and at home after you are discharged.
• Do not drive if you were given a sedative during the procedure.

Summary

• A supracervical hysterectomy is a surgery to remove the top part of the uterus while leaving the cervix in place.
• This surgery is usually done using a minimally invasive technique, which means it is done through small incisions instead of a large incision.
• The result is less pain, lower risk of infection, and shorter recovery time.

Supracervical Hysterectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have some discomfort, tenderness, swelling, and bruising at the surgical area. This normally lasts for about 2 weeks.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take aspirin. It can cause bleeding. Ask your health care provider when it is safe to use aspirin again.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.

Activity

• Get plenty of rest and sleep.
• Try to have someone home with you for 1–2 weeks to help you with everyday chores.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) or the limit that your health care provider tells you until he or she says that it is safe.
• Do not douche, use tampons, or have sex for at least 6 weeks or until your health care provider says it is safe to do so.

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Take showers instead of baths for 2–3 weeks or as told by your health care provider.

Eating and drinking

• Drink enough fluids to keep your urine clear or pale yellow.
• Do not drink alcohol until your health care provider says it is okay to do so.

General instructions

• Monitor your temperature for as long as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have redness, swelling, or pain around an incision.
• You have chills or fever.
• You have fluid or blood coming from an incision.
• An incision feels warm to the touch.
• You have pus or a bad smell coming from an incision.
• Your incisions break open.
• You feel dizzy or lightheaded.
• You have pain or bleeding when you urinate.
• You have diarrhea that does not go away.
• You have nausea and vomiting that do not go away.
• You have abnormal vaginal discharge.
• You have a rash.
• You have pain that does not go away when you take medicine.

Get help right away if:

• You have a fever and your symptoms suddenly get worse.
• You have severe abdominal pain.
• You have chest pain.
• You have shortness of breath.
• You faint.
• You have pain, swelling, or redness in your leg.
• You have heavy vaginal bleeding with blood clots.

Summary

• After the procedure, it is common to have some discomfort, tenderness, swelling, and bruising at the surgical site. This normally lasts for about 2 weeks.
• Get help right away if you have excessive vaginal bleeding or severe abdominal pain.