While total hysterectomy comprises removal of both the uterine corpus and the cervix, in a supracervical, or subtotal hysterectomy, only the uterine corpus is removed, preserving the cervix. Supracervical hysterectomy may be performed via either laparotomy or laparoscopically, the decision of approach resting on a number of factors that are discussed here. It has been suggested that supracervical hysterectomy would reduce postoperative sexual, urinary, and gastrointestinal function while reducing the risk of ureteric injury. However, in a Cochrane review of randomized trials, there was no difference in these outcomes between the two approaches, including long-term followup of up to nine years (2).  However, potential advantages of supracervical hysterectomy include reduced blood loss during or after surgery, shorter duration of surgery, and less postoperative fever and urinary retention. The rates of recovery, other complications, readmission rates and alleviation of pre-surgery symptoms have been found to be similar. Long-term postoperative cyclical vaginal bleeding is a unique outcome associated with supracervical hysterectomy likely seen as undesirable for most individuals.

Women who undergo a hysterectomy without removal of their cervix will need continued monitoring for cervical neoplasia through Pap smear and/or HPV screening and appropriate follow-up care should abnormalities be found. Supracervical hysterectomy should not be performed in cases where uterine malignancy or pre malignancy (eg atypical endometrial hyperplasia or EIN) is suspected or present.  Caution should be exercised when considering supracervical hysterectomy when the origin of the pain is thought to involve the cervix, such as is the case with obliteration of the cul-de-sac of Douglas by endometriosis.