Laparoscopic Supracervical Hysterectomy Pregnancy Risk

Laparoscopic supracervical hysterectomy refers to the procedure of subtotal hysterectomy using laparoscopic instruments. As supracervical hysterectomy involves leaving the cervix inside the body and only the removal of the uterus, it has certain risks for women undergoing the procedure in terms of future diseases and pregnancy. However, pregnancy risks are slim as a woman is unlikely to conceive and carry following removal of her uterus.

What is Laparoscopic Hysterectomy?

• Hysterectomy is a common surgical procedure for the removal of the uterus in women. The traditional method of hysterectomy involves surgery through an abdominal incision or via the vagina. Laparoscopic supracervical hysterectomy, on the other hand, is a non-invasive procedure that allows doctors to remove the uterus by using a telescope to view the organ and cut it free from the body. A minute incision above the vagina is then used to remove it.

What is the Difference between Hysterectomy and Supracervical Hysterectomy?

• Normal hysterectomy refers to total hysterectomy that involves removal of the uterus, the ovaries and the cervix. Supracervical hysterectomy leaves the cervix within the body. There is a good deal of disagreement among doctors about the more effective procedure and the benefits and/or side effects of leaving the cervix within the body. A systematic review by Lethaby A, Ivanova V, and Johnson N titled "Total versus subtotal hysterectomy for benign gynecological conditions" published in the Cochrane Database of Systematic Reviews 2006 found no significant health difference between the two cases.

What are the Associated Risks?

• Traditional supracervical hysterectomy was considered a more risky procedure as it was invasive and carried the possibility of damage to other organs including the ovaries and the cervix. Laparoscopic supracervical hysterectomy is considered safer in terms of these damages. However, a study by doctors Resad Pasic, Jeremy Scobee, and Blair Tolar and published in the February 2004 issue of the Journal of the American Association of Gynecologic Laparoscopists found that supracervical hysterectomy does increase the risk of ectopic pregnancy. While the overall percentage of incidences of ectopic or regular pregnancy is very low following supracervical hysterectomy, it is higher compared to total hysterectomy.

What are the Chances of Becoming Pregnant?

• Pregnancy is generally considered remote following a hysterectomy as the uterus has been removed. However, laparoscopic supracervical hysterectomy does not remove the ovaries or the fallopian tube and so there exists a very low risk of women becoming pregnant even after hysterectomy. The procedure also does not lead to menopause in women, which is considered to be another risk factor towards possible conception and pregnancy.

Who Should Choose Laparoscopic Supracervical Hysterectomy?

• The decision on whether you require a hysterectomy and the method of hysterectomy should ideally be left to the woman and her doctor. There have been arguments in favor of and against women undergoing a hysterectomy and even more so on the method of hysterectomy. Dr. J. M. Ayoubi and colleagues published a study in December 2003 issue of the European Journal of Obstetrics & Gynecology and Reproductive Biology in which they found that laparoscopic hysterectomy tends to have a milder effect on women's sexuality than other methods.

  However, it is not advisable for women who are childless and wish to undergo hysterectomy just to reduce pelvic pain or urinary problems. Such women should preferably seek alternative treatments as a hysterectomy will completely eliminate their chances of pregnancy in the future.
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