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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Painful, Heavy Periods Due To Fibroids, Hysterectomy Due. Have Ovarian Cyst. Cervix Removal Required?

Hello,
I am scheduled for a hysterectomy on November 8th due to painful, heavy periods (usually twice a month) caused by Fibroids. I also have ovarian cysts. I have tried other less invasive treatments and the hysterectomy was recommended by two physicians...I am a single mom and can't afford to miss so much of life. I am curious about removal of my cervix. I believe I have an extremely skill surgeon who is also an oncology expert. I do trust him. My ex is a surgeon that works with him and he trusts him. He suggests removal of my tubes, uterus, and cervix...no cancer is there but to minimize future issues. I see some studies that say to keep the cervix to avoid prolaspe of organs and protect my sexual well being. Any advice?
Thank you
Mon, 21 Oct 2013
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OBGYN,  's  Response
Hi,

Thanks for using HCM.

I understand your concern. Since I practice in India and such procedures are performed on a daily basis we remove the cervix. The reason is that cancer cervix is the leading gynec cancer in Indian females so we do not think twice before removing the cervix as our patients do not follow up with regular pap smears and all.
However, in the industrialized countries, cases of cancer cervix are less. Also some research studies have indicated that women with intact cervix were more satisfied with their sexual life compared to those that did not have it. However the results are conflicting and evidence in support of this is not robust. Personally, in my opinion, it is an individual perception. Cervix does not have much role in sexual pleasures. Also, potentially it may become malignant and the malignancies are fast growing.

The risk of prolapse depends upon the surgical skill and I perform procedures during hysterectomy [vault suspension] that decrease the risk of prolapse irrespective of weather the cervix is left or removed. You can discuss this with your surgeon and I am sure he will help you. Also, pelvic exercises help to decrease this risk.

So, It is a good idea to remove the cervix and decrease the risk of future cancer and the need for repeated screening.

I hope you find this answer useful.

Thanks a lot and have a good day.
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Painful, Heavy Periods Due To Fibroids, Hysterectomy Due. Have Ovarian Cyst. Cervix Removal Required?

Hi, Thanks for using HCM. I understand your concern. Since I practice in India and such procedures are performed on a daily basis we remove the cervix. The reason is that cancer cervix is the leading gynec cancer in Indian females so we do not think twice before removing the cervix as our patients do not follow up with regular pap smears and all. However, in the industrialized countries, cases of cancer cervix are less. Also some research studies have indicated that women with intact cervix were more satisfied with their sexual life compared to those that did not have it. However the results are conflicting and evidence in support of this is not robust. Personally, in my opinion, it is an individual perception. Cervix does not have much role in sexual pleasures. Also, potentially it may become malignant and the malignancies are fast growing. The risk of prolapse depends upon the surgical skill and I perform procedures during hysterectomy [vault suspension] that decrease the risk of prolapse irrespective of weather the cervix is left or removed. You can discuss this with your surgeon and I am sure he will help you. Also, pelvic exercises help to decrease this risk. So, It is a good idea to remove the cervix and decrease the risk of future cancer and the need for repeated screening. I hope you find this answer useful. Thanks a lot and have a good day.