Rescue radical trachelectomy for preservation of fertility in benign disease

Giuseppe Del Priore, Del Priore G, Allan S. Klapper, Klapper AS, Gurshumov E, Emil Gurshumov, Vargas MM, Marino Martinez Vargas, Ungar L, Laszlo Ungar, László Ungár, J Richard Smith, Smith JR, Jr. Smith
Fertility and sterility · 2010 · vol. 94(5) , pp. 1910.e5–1910.e7 · doi:10.1016/j.fertnstert.2010.03.019 · PMID:20416873 · W2076196346
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

This paper describes the technique and outcomes of a salvage radical trachelectomy procedure aimed at preserving fertility in patients with benign gynecological conditions.

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Abstract

ObjectivesTo report a series of patients treated with modified radical abdominal trachelectomy to preserve fertility in benign disease that would normally result in hysterectomy.DesignWe 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.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fertility Gynecologic Surgical Procedures Leiomyoma Myoma Uterine Diseases Uterine Neoplasms Adult Endometriosis Female Follow-Up Studies Gynecologic Surgical Procedures Humans Hydronephrosis Hydronephrosis Leiomyoma Myoma Treatment Outcome Uterine Diseases Uterine Neoplasms

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