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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11296
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am a 46 year old woman who has multiple large fibroids in

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Hello. I am a 46 year old woman who has multiple large fibroids in my uterus. I have had an MRI and there do not appear to be any in my cervix or ovaries. My specialist is going to remove my uterus and leave my ovaries but is leaving it up to me if I wish to remove the cervix or not. My question is this. What are the benefits and downside of removing the cervix? Am I more prone to vaginal prolapse without the cervix? What are the other possible problems having it removed? I understand that there is a chance of further fibroids forming in the cervix and, of course, the possibility of cervix cancer in the future; even though my pap test is clear at the moment. Thank you for your assistance.

For the most part, there is not good evidence for taking the cervix or leaving it. In my own opinion, it may depend on the skill of your surgeon. It's difficult to know exactly where the cervix begins and the uterus ends, so that sometimes leaving the cervix means leaving a part of the uterus and uterine lining. Then bleeding can occur.

It may be true that there is more chance of vaginal prolapse after total hysterectomy (removing the cervix as well), but I don't think there are good studies to prove it.

Fibroids don't usually form in the cervix, although they can. I've never seen growth of fibroids in a cervix that was left after hysterectomy.

As long as your Pap smears are normal, chance of cervical cancer is almost none.

There is a good article here about leaving the cervix or no

If it was me, and I had a good surgeon, I'd probably choose to keep the cervix. But I'd be happy either way.

Customer: replied 1 year ago.
Hello. Thank you for your very prompt response and I apologise for not getting back to you sooner. Could you please tell me why you would choose to leave the cervix, as I can not see any definite benefit whilst there would appear to be possible downsides to leaving it (part of uterus could be left for further fibroid growth and possible future cervix cancer risk). Thank you.

I suspect that there will be better support when the cervix is left in place. As I said, I don't think there are studies to prove it, but it makes sense to me.

And as I said, I think the risk of either future fibroid growth or cervix cancer risk is almost none.

Please click the rating stars. Thank you.

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