Persistent Bleeding After Laparoscopic Supracervical Hysterectomy

Kirsten J Sasaki, Kirsten Sasaki, Aarathi Cholkeri-Singh, Suela Sulo, Charles E Miller
JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2014 · vol. 18(4) , pp. e2014.002064 · doi:10.4293/jsls.2014.002064 · PMID:25516706 · W2327552335
article OA: hybrid CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study identified younger age and the presence of endometriosis as risk factors for persistent cervical stump bleeding after laparoscopic supracervical hysterectomy in 256 patients.

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Abstract

BACKGROUND AND OBJECTIVES: In our clinical experience, there seemed to be a correlation between cervical stump bleeding and adenomyosis. Therefore, we wanted to conduct a study to determine whether there was an actual correlation and to identify other risk factors for persistent bleeding after a laparoscopic supracervical hysterectomy. METHODS: The study included women who underwent laparoscopic supracervical hysterectomy from January 1, 2003, through December 31, 2012. Data were collected on age, postmenopausal status, body mass index (BMI), uterine weight, indication for hysterectomy, concomitant bilateral salpingo-oophorectomy (BSO), presence of endometriosis, surgical ablation of the endocervix, adenomyosis, presence of endocervix in the specimen, and postoperative bleeding. RESULTS: The study included 256 patients, of whom 187 had no postoperative bleeding after the operation, 40 had bleeding within 12 weeks, and 29 had bleeding after 12 weeks. The 3 groups were comparable in BMI, postmenopausal status, uterine weight, indication for hysterectomy, BSO, surgical ablation of the endocervix, adenomyosis, and the presence of endocervix. However, patients who had postoperative bleeding at more than 12 weeks were significantly younger (P = .002) and had a higher rate of endometriosis (P < .001). CONCLUSIONS: Risks factors for postoperative bleeding from the cervical stump include a younger age at the time of hysterectomy and the presence of endometriosis. Therefore, younger patients and those with endometriosis who desire to have no further vaginal bleeding may benefit from total hysterectomy over supracervical hysterectomy. All patients who are undergoing supracervical hysterectomy should be counseled about the possible alternatives, benefits, and risks, including continued vaginal bleeding from the cervical stump and the possibility of requiring future treatment and procedures.

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Condition tags

mesh:D004715endometriosisadenomyosis

MeSH descriptors

Hysterectomy Laparoscopy Postoperative Hemorrhage Uterine Hemorrhage Adult Endometriosis Endometriosis Female Humans Hysterectomy Hysterectomy Incidence Laparoscopy Middle Aged Postoperative Hemorrhage Postoperative Hemorrhage United States United States Uterine Hemorrhage

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References (24)

Cited by (3)

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