Trachelectomy following supracervical hysterectomy
- Rosanne M Kho, MD
Rosanne M Kho, MD
- Associate Professor
- Head, Section of Urogynecology
- Co-Director, MIGS Fellowship Program
- Columbia University Medical Center
- Javier F Magrina, MD
Javier F Magrina, MD
- Barbara Woodward Lipps Professor
- Division of Gynecologic Oncology
- Department of Gynecologic Surgery
- Mayo Clinic, AZ
Trachelectomy to remove the cervical stump after prior supracervical hysterectomy is typically performed to manage cervical symptoms or disease that develops postoperatively, such as abnormal bleeding or abnormal cytology. This topic will review the indications for trachelectomy after supracervical hysterectomy, as well as techniques and possible complications. Radical trachelectomy performed as fertility sparing surgery in women with early stage cervical cancer is discussed separately. (See "Fertility-sparing surgery for cervical cancer".)
Trachelectomy is typically performed after prior supracervical hysterectomy to treat disease or symptoms referable to the cervical stump. It may also be performed in conjunction with other pelvic surgery (eg, oophorectomy, bowel resection). After supracervical hysterectomy, new cervical symptoms will develop in up to one-quarter of women [1-4].
In the largest series of trachelectomy from a single institution (n = 310 cases from 1974 to 2003), the most common indications were :
●Prolapse (52 percent)
●Pelvic mass (25 percent)
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