Anatomy After Hysterectomy: What Remains & What's Removed

A hysterectomy removes the uterus. The extent of additional removal defines the subtype.

Hysterectomy Types

Type	Removed	Retained
Total (complete)	Uterus + cervix	Ovaries, fallopian tubes, vagina
Supracervical (subtotal)	Uterus only	Cervix, ovaries, tubes, vagina
Total + BSO	Uterus, cervix, both ovaries, tubes	Vagina
Radical	Uterus, cervix, upper vagina, parametria, nodes	Ovaries (often), lower vagina

Structures Typically Preserved

• Vagina: Closed at apex (vaginal cuff); retains sexual function.
• Ovaries: If preserved, continue hormone production & ovulation (until natural menopause).
• Fallopian tubes: Often removed (salpingectomy) for ovarian cancer risk reduction, even if ovaries kept.
• Ureters, bladder, rectum: Intact; carefully dissected during surgery.

Consequences

• No menstruation (if uterus/cervix gone).
• No pregnancy.
• If ovaries removed → surgical menopause (unless HRT).
• Pelvic floor support may change; vaginal cuff dehiscence rare but serious.

Surgical Approaches

• Abdominal, vaginal, laparoscopic, robotic — chosen by indication, uterus size, surgeon expertise.