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.
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.