A hysterectomy is a surgical procedure involving the removal of the uterus (womb). It is typically reserved for severe conditions like unresponsive uterine fibroids, endometriosis, or certain cancers when other treatments have failed. The extent of the surgery varies significantly, leading to confusion regarding procedures labeled “partial” or “total.” Medical professionals use specific anatomical terms to precisely define what tissues are removed. Hysterectomy classification is fundamentally based on whether the cervix, the lower part of the uterus, is removed along with the main uterine body.
Defining the Terminology: Subtotal or Supracervical Hysterectomy
The procedure commonly referred to as a “partial hysterectomy” is medically known as a Subtotal Hysterectomy or a Supracervical Hysterectomy. These terms are used interchangeably and describe the removal of only the upper part of the uterus. The defining characteristic is that the cervix, the lower portion of the uterus, is intentionally left in place.
The term “subtotal” accurately describes removing a portion of the complete organ (the main uterine body). “Supracervical” is also descriptive, literally meaning “above the cervix,” clarifying that the cervix remains intact. Leaving the cervix may potentially shorten operating time, though research suggests it offers no significant advantage over a total hysterectomy regarding sexual function or urinary health.
A woman undergoing a subtotal hysterectomy will no longer experience menstrual periods because the uterine cavity lining is removed. However, retaining the cervix means there is a small possibility of light monthly bleeding or spotting, sometimes called a “mini-period,” from the remaining cervical tissue. Patients with a retained cervix must continue to receive regular cervical cancer screenings, such as Pap tests, to monitor the remaining tissue.
The Crucial Comparison: Total Hysterectomy
To understand the subtotal procedure, it is helpful to compare it to the Total Hysterectomy. The difference between the two surgical types centers entirely on the fate of the cervix. In a total hysterectomy, the surgeon removes the entire uterus, including the upper body of the womb and the cervix.
The removal of the cervix is the single anatomical feature differentiating a total hysterectomy from a subtotal one. This more extensive procedure is often selected when the cervix is affected by conditions like dysplasia or cancer, or to eliminate the risk of future cervical cancer entirely. For non-cancerous conditions, the decision to remove the cervix is based on a patient’s medical history, risk factors, and preferences.
The complete removal of the cervix eliminates the need for future cervical cancer screening. A total hysterectomy results in the formation of a vaginal cuff, which is the closed-off top of the vagina where the cervix was previously attached. This procedure is the most common type of hysterectomy performed in the United States.
Associated Procedures: Oophorectomy and Salpingectomy
A frequent source of confusion for patients is whether the removal of other reproductive organs changes the classification of the hysterectomy itself. The medical classification of a hysterectomy as subtotal or total is determined solely by the removal or retention of the uterus and cervix. The removal of the ovaries or fallopian tubes is considered an additional, separate procedure that may be performed concurrently.
The surgical removal of one or both ovaries is called an oophorectomy, and the removal of one or both fallopian tubes is called a salpingectomy. When these procedures are performed together with a hysterectomy, the full name of the surgery reflects all parts removed. For example, a surgery that removes the uterus, cervix, both fallopian tubes, and both ovaries is formally called a total hysterectomy with bilateral salpingo-oophorectomy.
These associated procedures are often performed to reduce the risk of future ovarian cancer, particularly a prophylactic salpingectomy, or to treat existing conditions like endometriosis or ovarian masses. Despite being frequently combined with a hysterectomy, the naming convention for the hysterectomy portion remains fixed: it is classified as total if the cervix is removed, or subtotal/supracervical if the cervix is left intact.