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Vaginal Trachelectomy Following Laparoscopic Supracervical Hysterectomy and Sacrocervicopexy

Minaglia, Steven MD, MBA

Female Pelvic Medicine & Reconstructive Surgery: March/April 2014 - Volume 20 - Issue 2 - p 116–118
doi: 10.1097/SPV.0b013e3182a09a57
Case Report

Background Current evidence supports cervical preservation at the time of abdominal prolapse repair using synthetic mesh to minimize vaginal mesh extrusion. This report aims to describe management of benign cervical disease following laparoscopic sacrocervicopexy including successful trachelectomy performed vaginally.

Case A 70-year-old sexually active woman presented with symptomatic pelvic organ prolapse and stress urinary incontinence. Her Papanicolaou smears over several years were unremarkable, and she had a benign endocervical polyp removed in the office 3 months before surgery. She underwent an uncomplicated robotic-assisted laparoscopic supracervical hysterectomy and sacrocervicopexy. She presented 8 months after surgery with persistent vaginal spotting after intercourse and was found to have a recurrent endocervical polyp. Ultimately, she underwent uncomplicated trachelectomy performed vaginally with resolution of her symptoms.

Conclusions Retention of the cervix at the time of mesh-augmented abdominal prolapse repairs introduces a unique set of evaluation and management considerations for benign cervical disease. Trachelectomy performed vaginally was successful and uncomplicated in this case.

Vaginal trachelectomy is feasible for benign cervical disease following laparoscopic supracervical hysterectomy and sacrocervicopexy. Supplemental digital content is available in the text. Supplemental Digital Content is available in the text.

From the Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics & Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.

Reprints: Steven Minaglia, MD, MBA, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St, Suite 824, Honolulu, HI 96826. E-mail: minaglia@hawaii.edu.

The author declares there is nothing to disclose.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.fpmrs.net).

© 2014 by Lippincott Williams & Wilkins