Long-term outcomes, in terms of cervical stump symptoms and overall patient satisfaction, were studied in women both after abdominal (SAH) and laparosocopic (LSH) supracervical hysterectomies. Altogether, 134 women had SAH and 315 women LSH during 2004 and 2005 at our department. The response rate of this retrospective study was 79%. Persistent vaginal bleeding after the surgery was reported by 17% in the SAH group and 24% in the LSH group. Regular bleeding was reported by only 8% in both study groups, and the women rarely found the bleeding bothersome. The women reported a significant pain reduction after the surgery, but women having a hysterectomy because of pain and/or endometriosis should be informed about the possibility of persistent symptoms. The overall patient satisfaction after both procedures was high, but the patients should have proper preoperative information about the possibility of cervical stump symptoms after any supracervical hysterectomy. 1. Introduction Hysterectomy is the ultimate treatment for women suffering from symptomatic fibroids, abnormal uterine bleeding and uterine malignancy and is one of the most frequent performed surgical procedures [1, 2]. There is no universal agreement about the optimal method of hysterectomy—abdominal, laparoscopic, or vaginal—and there is a question whether the cervix should be removed as a routine part of the hysterectomy. The world’s first successful supracervical abdominal hysterectomy (SAH) was performed in 1853 by Gilman Kimball in USA. Since then, the advantages and disadvantages of supracervical versus total hysterectomy technique have been discussed, with variable enthusiasm in different time periods and between countries. More recently, there has been a swing back to supracervical, with marked geographic variations [3–6]. In Scandinavia, the ratio of supracervical to total hysterectomy is traditionally high. At our department in Oslo, Norway, supracervical hysterectomy is the recommended procedure for women with benign conditions requiring hysterectomy and with no previous history of cervical dysplasia. Although laparoscopic supracervical hysterectomy (LSH) has gradually replaced abdominal hysterectomy, SAH is still performed in women where laparoscopic or vaginal approach is not feasible, mainly due to significant enlarged uterus [7]. Opponents of supracervical hysterectomy, either it is performed open or by a laparoscopic approach, often seem to be concerned with the risk of cervical stump symptoms such as vaginal bleeding and pelvic pain following the hysterectomy, causing patient
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