OB-GYN (Obstetrician-Gynecologist) Questions Hysterectomy

How do a partial and full hysterectomy differ?

I'm 36 and I was just diagnosed with uterine cancer. My doctors are trying to determine whether a partial or full hysterectomy will be necessary. What is the difference, other than a partial is just a section? Why would one be beneficial over the other?

5 Answers

The term partial and full is understood differently by the public. Partial: a section is removed, full: entire uterus removed. For uterine cancer if surgery is to be pursued (in a 35 yo, sometimes hormonal therapy is used for preservation of fertility, and defer surgery to a future date) it means full hysterectomy. The remaining question is, at the age of 35, does one also remove the ovaries? Furthermore, does one need to perform additional surgical steps to rule out spread of disease?
If you have uterine cancer, partial hysterectomy (leaving the cervix) is not recommended, you need a complete hysterectomy.
Take care!
A hysterectomy is the surgical removal of the uterus. This is called total hysterectomy. Many people think that a "partial" means just the uterus, and leaving the ovaries behind, when in reality there is no such thing. A total hysterectomy WITH a bilateral salpingoophorectomy is removal of the uterus, tubes, and ovaries, along with the cervix.

Uterine cancer varies in type, however endometrioid endometrial adenocarcinoma is what I would venture to guess is what you are describing. It is a very common cancer, however, in your age, not so much.

Your surgeon is probably wondering about removing your ovaries and weighing the risks and benefits.

1.) Can allow full surgical staging
2.) Practically eliminates risk of a future ovarian cancer

1.) Immediate surgical menopause (hot flashes, night sweats, mood swings)
2.) Decreased bone health as you get older
3.) Questionable cardiovascular risks

If it is endometrial cancer, then your CANNOT use hormones because the cancer is estrogen driven.

Depending on what the initial biopsy showed (FIGO Grade 1 for instance), some gynecologic oncologists can offer a Mirena IUD or megestrol tablets or even Depo Provera injections instead of surgery. This will, however, require serial biopsies of the lining of the uterus.

All of these things must be taken into consideration. Best of luck!
In the medical world, a "full" hysterectomy means the uterus and cervix are removed while a "partial" hysterectomy means the cervix is separated from the uterus and left behind. Lay people often refer to "full" as taking the ovaries as well and "partial" as leaving the ovaries. That is incorrect. Hysterectomy has nothing to do with the ovaries and refers only to the
uterus and cervix. That said, the common treatment for uterine cancer is removal of the uterus, Fallopian tubes, cervix, and ovaries as well as sampling for possible spread of the cancer. This is known as a "staging procedure" because it gives more information as to the stage of the cancer.
Hope this helps. Good luck!
As a general rule, a "partial" hysterectomy involves removal of the uterus, but retains the ovaries, while a "total" hysterectomy removes the uterus, tubes, and ovaries.