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Fertil Steril. 2010 Oct;94(5):1910.e5-7. doi: 10.1016/j.fertnstert.2010.03.019. Epub 2010 Apr 22.

Rescue radical trachelectomy for preservation of fertility in benign disease.

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1
Department of Gynecologic Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

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.

[Indexed for MEDLINE]

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