[Management of symptomatic fibroids: role of supracervical hysterectomy and laparoscopy]

Abstract

Objective: Evaluate the relevance of supracervical hysterectomy, in particular by laparoscopy, in the treatment of symptomatic myomas.

Methods: Examination of the literature in the MEDLINE and Cochrane databases, between 1960 and 2010.

Results: Because of reduced or identical complications when performed in laparotomy or laparoscopy, respectively, subtotal hysterectomy is a possible alternative to total hysterectomy (grade B). In case of previous or current cervical dysplasy, total hysterectomy is preferable to subtotal hysterectomy (grade B). Conical resection of the endocervix is recommended in case of subtotal hysterectomy (grade C). There is no advantage to subtotal hysterectomy for the sole purpose of avoiding functional or sexual pelvic troubles (grade A).

Conclusion: In case of symptomatic myomas, subtotal hysterectomy can be beneficial.