Complications after fertility-preserving radical trachelectomy.

OBJECTIVE

We report a case of cervical cancer treated by radical trachelectomy complicated by pelvic inflammatory disease, tubo-ovarian complex, and infertility.

DESIGN

Case report.

SETTING

Tertiary referral university hospital.

PATIENT(S): A 35-year-old with stage IB1 cervical cancer underwent an uneventful radical vaginal trachelectomy. Three years later she presented with pelvic pain and fever after a new partner. Cervical chlamydia was positive, and sonography showed bilateral complex adnexal masses. Her symptoms resolved with prolonged IV, followed by oral, antibiotics. Temperature, cultures, and blood tests have all normalized but her sonogram demonstrates persistent bilateral hydrosalpinx. She has not conceived and underwent laparoscopic salpingectomy prior to IVF. She remains cancer free.

INTERVENTION(S): Radical vaginal trachelectomy, salpingectomy and assisted reproductive techniques.

MAIN OUTCOME MEASURE(S): Cancer disease status and fertility preservation.

RESULT(S): Three years later, the patient remains cancer free but has been unable to conceive or carry a pregnancy.

CONCLUSION(S): Fertility-preserving cancer treatments are relatively new. Complications may be encountered that must be reported, collected, and analyzed to maximize cancer cure and fertility preservation.