A cervical stump is the portion of the cervix that remains in your body after a supracervical (also called subtotal) hysterectomy. In this type of hysterectomy, the surgeon removes the main body of the uterus but intentionally leaves the cervix in place. The remaining cervical tissue is what doctors refer to as the cervical stump.
How a Cervical Stump Is Created
Hysterectomies fall into two broad categories based on how much tissue is removed. A total hysterectomy removes both the uterine body and the cervix. A supracervical hysterectomy removes only the uterine body while preserving the cervix. The preserved cervix, now detached from the uterus above it, becomes the cervical stump.
Supracervical hysterectomy gained popularity partly because it can be performed laparoscopically with a shorter operating time, and some surgeons believed that keeping the cervix would better support the pelvic floor or preserve sexual function. The procedure is sometimes chosen for conditions like fibroids or heavy bleeding when the cervix itself appears healthy.
Does Keeping the Cervix Improve Outcomes?
One of the main reasons patients and surgeons opt for a supracervical approach is the idea that retaining the cervix leads to better pelvic support, sexual satisfaction, or bladder function. Long-term data tells a more nuanced story. The TOSH (Total or Supracervical Hysterectomy) trial followed patients for nine years and found no significant differences between the two approaches in urinary incontinence, voiding problems, pelvic prolapse symptoms, or overall quality of life.
Sexual function results were similarly close. Women in the supracervical group had fewer sexual problems at baseline and maintained that advantage, but neither group showed a statistically significant difference in sexual function scores over time. Interestingly, the total hysterectomy group showed a significant improvement in the ability to have and enjoy sex after surgery. In short, keeping the cervix doesn’t appear to offer the clear advantages many patients expect.
Cyclical Bleeding After Surgery
One of the more surprising experiences for people with a cervical stump is ongoing vaginal bleeding that can feel like a light period. This happens because small amounts of endometrial tissue (the lining that normally sheds during menstruation) can remain on the cervical stump after surgery. Since the ovaries typically stay in place and continue producing estrogen, that leftover tissue responds to hormonal cycles just as it did before.
Reported rates of persistent bleeding vary widely, from under 1% to as high as 25%, though most studies put the number between 5% and 10%. In some cases, fragments of uterine tissue from the surgical process itself become embedded in the stump and cause bleeding. Endometriosis on the cervical stump is another possible explanation. For most people, the bleeding is light and manageable, but it can be confusing if you weren’t told to expect it.
You Still Need Pap Smears
This is the single most important practical detail for anyone living with a cervical stump: because your cervix is still present, you need to continue routine cervical cancer screening on the same schedule as someone who never had a hysterectomy. That means regular Pap smears and, depending on your age, HPV testing.
This is a key distinction from total hysterectomy. Major guidelines from the American Cancer Society, ACOG, and the U.S. Preventive Services Task Force all agree that women who have had their cervix completely removed for non-cancerous reasons can stop cervical screening entirely. That guidance does not apply to you if you have a cervical stump. Your cervical tissue can still develop precancerous changes or, rarely, cervical cancer.
Cancer Risk in the Cervical Stump
The risk of developing cancer in a cervical stump is low but real. About 0.3% of patients who undergo a cervix-sparing hysterectomy will develop cervical stump cancer. When it does occur, it accounts for roughly 1.6% to 4.4% of all cervical cancer cases. These numbers are small, but they underline why continued screening matters. The same HPV-related processes that drive cervical cancer in an intact cervix apply equally to cervical tissue that has been left behind.
Other Conditions That Can Develop
Beyond cancer, the cervical stump can develop several conditions over time. Fibroids can grow in or on the remaining cervical tissue, even years after the original hysterectomy. Precancerous cell changes (cervical dysplasia) can appear just as they would in anyone with a cervix. The stump can also prolapse, dropping lower in the vaginal canal as pelvic floor support weakens with age.
When any of these problems become symptomatic, treatment often involves a second surgery called a trachelectomy, which removes the cervical stump. Common reasons for trachelectomy include persistent pain, abnormal bleeding that doesn’t resolve, precancerous or cancerous findings on screening, or prolapse. This surgery is generally more complex than the original hysterectomy because of scar tissue from the first procedure.
What to Know If You Have One
If you’ve had a supracervical hysterectomy, the most actionable thing you can do is make sure your healthcare provider knows your cervix is still present. This sounds obvious, but it’s a surprisingly common source of confusion. Medical records sometimes note “hysterectomy” without specifying the type, and both patients and providers may assume cervical screening is no longer needed.
Light cyclical spotting is relatively common and usually not dangerous, but any new or heavy bleeding, pelvic pain, or unusual discharge should be evaluated. If you’re experiencing symptoms that started after your hysterectomy and haven’t resolved, imaging with MRI can help assess the cervical stump for fibroids, endometriosis, or other structural changes. MRI is particularly useful because it can distinguish normal post-surgical tissue from abnormal growths.