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Uterine transposition: technique and a case report.
Reitan Ribeiro1, Juliano Camargo Rebolho1, Fernanda Keiko Tsumanuma2
1Surgical Oncology Department, Erasto Gaertner Hospital, Curitiba, Brazil.
Fertility and Sterility
|July 13, 2017
Summary
Uterine transposition successfully preserved fertility in a rectal cancer patient undergoing pelvic radiotherapy. The uterus was moved, treated, and returned, maintaining ovarian function and allowing future childbearing potential.
Area of Science:
- Reproductive Medicine
- Surgical Oncology
- Gynecologic Oncology
Background:
- Fertility preservation is a critical concern for young women diagnosed with rectal cancer requiring pelvic radiotherapy.
- Standard fertility preservation methods may not always be feasible or sufficient for all patients.
Observation:
- A case report details the first uterine transposition for fertility preservation in a 26-year-old patient with locally advanced rectal adenocarcinoma.
- The uterus was laparoscopically moved to the upper abdomen, outside the radiation field, prior to neoadjuvant therapy and radiotherapy.
- Following radiotherapy and rectosigmoidectomy, the uterus was repositioned into the pelvis.
Findings:
- The patient maintained uterine and ovarian function throughout treatment, evidenced by regular menstruation and normal hormone levels.
- Post-reimplantation, menstruation resumed within two weeks, and the cervix appeared normal after six weeks.
- Eighteen months post-surgery, the uterus remained healthy with no signs of disease recurrence.
Implications:
- Uterine transposition presents a potential fertility-sparing strategy for women of reproductive age with rectal cancer requiring pelvic radiation.
- Further research is necessary to evaluate the long-term viability, efficacy, and safety of this surgical technique.
- This approach may offer a viable option for women desiring future childbearing after pelvic radiotherapy.
