A Cochrane review included 9 trials with a total of 1 553 women. There was no evidence of a difference in the rates of incontinence, constipation or measures of sexual function between total hysterectomy (TH) and subtotal hysterectomy (STH), either in the short term (up to two years post-surgery) or long term (nine years post-surgery). Length of surgery and amount of blood lost during surgery were reduced during subtotal hysterectomy when compared with total hysterectomy, but there was no evidence of a difference in the odds of transfusion. Febrile morbidity was less likely and ongoing cyclical vaginal bleeding one year after surgery was more likely after subtotal when compared with total hysterectomy. There was no difference in the rates of other complications, recovery or readmission rates.
Comment: The quality of evidence is downgraded by study quality (lack of blinding in half of trials). The possibility of cervical cancer after subtotal hysterectomy is not assessed in this review.