Rescue radical trachelectomy for preservation of fertility in benign disease

Giuseppe Del Priore, Allan S. Klapper, Emil Gurshumov, Marino Martinez Vargas, Laszlo Ungar, J. Richard Smith

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objectives: To report a series of patients treated with modified radical abdominal trachelectomy to preserve fertility in benign disease that would normally result in hysterectomy. Design: We reviewed all cases of radical abdominal trachelectomy performed for nonneoplastic indications. Patient(s): Of the >160 radical abdominal trachelectomies we performed, four cases were performed for benign indications. One patient had a 10-year history of progressive endometriosis with worsening hydronephrosis, failed medical therapy, and infertility. Two myomectomy patients had intraoperative consultation and a third had preoperative consultation for large lower segment/cervical myomas with conversion to trachelectomy rather than hysterectomy. Intervention(s): Modified radical trachelectomy was successfully completed in all patients. Main Outcome Measure(s): We measured the successful completion of the surgery without hysterectomy, complications, and follow-up. Result(s): Hysterectomy was avoided in all patients, and all resumed normal menses. There were no intraoperative or postoperative complications. One required hysterectomy for recurrence 1 year later, and the remainder were symptom free at 1-5 years of follow-up. Conclusion(s): Although traditionally performed with cervical cancer, radical abdominal trachelectomy can be modified to preserve fertility for benign indications that would otherwise require hysterectomy.

Original languageEnglish (US)
Pages (from-to)1910.e5-1910.e7
JournalFertility and Sterility
Volume94
Issue number5
DOIs
StatePublished - Oct 2010

Keywords

  • fertility preservation
  • Radical abdominal trachelectomy
  • uterine preservation

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Medicine(all)

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  • Cite this

    Del Priore, G., Klapper, A. S., Gurshumov, E., Vargas, M. M., Ungar, L., & Smith, J. R. (2010). Rescue radical trachelectomy for preservation of fertility in benign disease. Fertility and Sterility, 94(5), 1910.e5-1910.e7. https://doi.org/10.1016/j.fertnstert.2010.03.019