Laparoscopic supracervical hysterectomy is also known as LSH and it is a kind of hysterectomy that makes it possible for women to keep their cervix even though a part of the uterus is removed. Some of the patients are opting for laparoscopic hysterectomy of the supracervical kind because they feel like their cervix helps them maintain their sexual function and it also offers them pelvic organ support.
There have been some studies conducted regarding laparoscopic hysterectomy of the supracervical kind and these have shown that the procedure itself is shorter and the patient has to spend less time in the hospital not to mention that there are fewer possible complications than in case of laparoscopic assisted vaginal hysterectomy.
On the other hand there is no official data that would say that there is any difference regarding the sexual function in case of women undergoing hysterectomy with or without removing the cervix.
The indications of the laparoscopic supracervical hysterectomy are just the same as in case of laparoscopic assisted vaginal hysterectomy. In case there are any signs or symptoms of urinary incontinence or pelvic organ prolapse, the doctors can change the techniques used in order to take are of these problems as well.
You might see that the laparoscopic hysterectomy of the supracervical kind is very similar to the laparoscopic assisted vaginal hysterectomy and this is why the contraindications are also similar, like if the uterus is greater than 20-22-week size or in case you have some serious medical condition and it wouldn’t be safe for you to undergo an operation that includes general anesthesia.
Even more, the patients with abdominal PAP smears, pain with intercourse, enlarged cervix or pain on palpation should not consider having laparoscopic supracervical hysterectomy.
Laparoscopic assisted vaginal hysterectomy is known to have numerous possible complications and you have to think about the fact that laparoscopic hysterectomy of the supracervical kind has even more because the cervix remains behind.
There have been some studies on this topic, and these have found that 25% of the patients continued to menstruate and 10% had vaginal discharge. Because the cervix is attached to the vagina, the length of it might be compromised during laparoscopic supracervical hysterectomy.
Naturally the doctors are trying to minimize this. In case they don’t have to work with the cervix, there is no reason for them to touch the vaginal tissue. If there is no prolapse before the procedure then it is natural for the doctors to leave the cervix in place. The uterus will be removed, but the length of the vagina will be maintained and so the procedure itself is less invasive. Also in this case the pelvic organic support will be maintained.
Nonetheless in case of a patient with prolapse prior to laparoscopic hysterectomy of the supracervical kind there could be enteroceles between the cervix and the vagina and so it may not make sense to try and maintain the cervix because it would be more difficult to rebuild the vagina after laparoscopic supracervical hysterectomy.