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Repair of the Threatened Feminine Identity: Experience of Women With Cervical Cancer Undergoing Fertility Preservation Surgery

Komatsu, Hiroko PhD, RN; Yagasaki, Kaori MSN, RN; Shoda, Rie RN; Chung, Younghui RN; Iwata, Takashi PhD, MD; Sugiyama, Juri MD; Fujii, Takuma PhD, MD

doi: 10.1097/NCC.0b013e3182888c13

Background: Fertility preservation is important for women of reproductive age with cervical cancer. The underlying reasons behind suboptimal reproductive results after successful fertility-preserving surgery have not yet been fully revealed.

Objective: The objective of this study was to explore the experience of fertility preservation with radical trachelectomy from the perspective of women with cervical cancer.

Methods: We conducted interviews with women with cervical cancer who underwent radical trachelectomy using a Grounded Theory methodology with a theoretical framework of symbolic interactionism.

Results: Our findings articulate a process in which feminine identity is first threatened by a diagnosis of cancer, then repaired by fertility preservation with radical trachelectomy, and finally reconstructed after the surgery, through interactions with self, others, and external events in women with cervical cancer. Feeling incomplete as a woman because of the loss of the uterus was a critical factor in the women’s feeling that their feminine identity was threatened. Thus, fertility preservation was significant for these women. The meaning of fertility preservation varied among the women, and their life perspectives were therefore distinct after the surgery.

Conclusions: Women with cervical cancer who undergo radical trachelectomy experience an identity transformation process, and child bearing is not the only expected outcome of fertility preservation.

Implications for Practice: Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients’ needs and provide appropriate individual care.

Author Affiliations: Faculty of Nursing and Medical Care (Dr Komatsu and Ms Yagasaki) and Department of Obstetrics and Gynecology, School of Medicine (Drs Iwata, Sugiyama, and Fujii), Keio University, and Keio University Hospital (Mss Shoda and Chung), Tokyo, Japan.

This study was supported by Keio Gijuku Academic Transformation Funds for the years 2011 and 2012. Dr Komatsu has received a research grant from Keio Gijuku Academic Transformation Funds for the years 2011 and 2012. Dr Fujii has received speaker’s honoraria form MSD Company.

Our results for the first 3 participants were presented at the 17th International Conference of Cancer Nursing.

The authors have no conflicts of interest to disclose.

Correspondence: Hiroko Komatsu, PhD, RN, Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan (

Accepted for publication December 21, 2012.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins