Long term outcome following laparoscopic supracervical hysterectomy

E. Okaro, E O Okaro, K D Jones, Kevin Jones, Chris Sutton, C Sutton
BJOG: An International Journal of Obstetrics & Gynaecology · 2001 · vol. 108(10) , pp. 1017–1020 · doi:10.1111/j.1471-0528.2001.00252.x · PMID:11702830 · W2021712936
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Laparoscopic supracervical hysterectomy resulted in cervical stump symptoms requiring further surgery in 24.3% of patients, with past endometriosis treatment being a significant predictor.

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Abstract

OBJECTIVES: To assess the long term outcome of laparoscopic supracervical hysterectomy. DESIGN: Retrospective study. SETTING: Minimal Access Surgical Unit, Department of Gynaecology, Royal Surrey County Hospital, Surrey. METHODS: Analysis of patient case records. POPULATION: Seventy consecutive women who had a laparoscopic supracervical hysterectomy. OUTCOME MEASURES Symptoms related to the cervical stump and the need for further surgery. RESULTS: The mean time of patient follow up was 66 months (range 52-84). The mean time from initial procedure to second treatment was 14 months (range 3-53). Seventeen women (24.3%) reported symptoms related to the cervical stump, and all required further surgery. The cervical stump was removed in 16 (22.8%). One patient had laparoscopic adhesiolysis only and two had a laparotomy and trachelectomy because the bowel was adherent to the cervical stump. Nine had a laparoscopically assisted cervical trachelectomy as the sole procedure. Five had laser treatment to endometriotic deposits, and laparoscopically assisted cervical trachelectomy. Histological analysis showed normal cervical tissue in six (35.3%). Endometriosis was detected in four cervical stumps (23.5 %), residual endometrium in another four (23.5 %) cases, and chronic cervicitis, mild CIN and a mucocoele in a further three patients. Of the 17 women who reported cervical stump symptoms, 14 (82.3%) had been treated for endometriosis in the past, compared with 17/53 (32%) who did not have symptoms (P < 0.0002, chi2 test). CONCLUSIONS: Symptoms related to the cervical stump requiring further surgery frequently occur following a laparoscopic supracervical hysterectomy.

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Condition tags

mesh:D004412endometriosis

MeSH descriptors

Dysmenorrhea Hysterectomy Laparoscopy Menorrhagia Adult Cervix Uteri Cervix Uteri Dysmenorrhea Female Follow-Up Studies Humans Hysterectomy Hysterectomy Laparoscopy Menorrhagia Middle Aged Reoperation Retrospective Studies Treatment Outcome

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