Version June 2024
| Subtotal/supracervical |
| Subtotal/supracervical hysterectomy. The uterus is removed. The superior portion of the cervix is amputated; the remainder of the cervix is conserved. Intrafascial hysterectomy is a subtype of subtotal hysterectomy in which the uterosacral ligaments are conserved.[1] |
| Piver-Rutledge-Smith Classification[2] |
| Class I |
| Extrafascial hysterectomy. The fascia of the cervix and lower uterine segment, which is rich in lymphatics, is removed with the uterus. |
| Class II |
| Modified radical hysterectomy. The uterine artery is ligated where it crosses over the ureter, and the uterosacral and cardinal ligaments are divided midway towards their attachment to the sacrum and pelvic sidewall, respectively. The upper one-third of the vagina is resected. |
| Class III |
| Radical hysterectomy. The uterine artery is ligated at its origin from the superior vesical or internal iliac artery. Uterosacral and cardinal ligaments are resected at their attachments to the sacrum and pelvic sidewall. The upper one-half of the vagina is resected. |
| Class IV |
| Radical hysterectomy. The ureter is completely dissected from the vesicouterine ligament, the superior vesical artery is sacrificed, and three-fourths of the vagina is resected. |
| Class V |
| Radical hysterectomy. There is additional resection of a portion of the bladder or distal ureter with ureteral reimplantation into the bladder. |
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