Wertheim's radical hysterectomy (Type III/Piver-Rutledge Type III) differs from Type II (modified radical) hysterectomy primarily in that it includes:
- A Removal of the upper one-third of the vagina and complete parametrectomy to the pelvic sidewall ✓
- B Removal of only the medial half of the cardinal ligament
- C Preservation of the uterosacral ligaments
- D Extrafascial removal of the uterus without parametrial resection
Correct answer: A. Removal of the upper one-third of the vagina and complete parametrectomy to the pelvic sidewall
Explanation
Type III (Wertheim's) radical hysterectomy involves complete parametrectomy — resection of the cardinal and uterosacral ligaments at the pelvic sidewall — along with removal of the upper one-third of the vagina. Type II (modified radical) removes only the medial half of the cardinal and uterosacral ligaments and the upper 1–2 cm of vagina, preserving more neurovascular supply and reducing bladder dysfunction. Type I is simple (extrafascial) hysterectomy.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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