title: The fate of the ovaries after radical hysterectomy and ovarian transposition.
abstract: To assess the effectiveness of lateral ovarian transposition in preserving normal ovarian function, the medical records of 200 consecutive women with stage I-IIA cervical cancer treated primarily with radical hysterectomy and pelvic lymphadenectomy were reviewed. Lateral ovarian transposition was performed at the time of radical hysterectomy in 132 (66%) patients and 28 (21%) received postoperative pelvic radiation therapy. Menopausal symptoms (vaginal dryness, hot flushes) and follicle-stimulating hormone (FSH) levels were used to define ovarian function. Only 3/104 (2.9%) patients who underwent lateral ovarian transposition without postoperative pelvic radiotherapy experienced menopausal symptoms; however, FSH levels in all three cases suggested continued ovarian function. In 14/28 (50%) patients who received postoperative pelvic radiation therapy ovarian failure occurred. The risk of ovarian failure with pelvic radiation therapy after lateral ovarian transposition was significant (RR = 17.3; 95% CI = 5.35-56.13). The incidence of adnexal disease in transposed ovaries requiring analgesics or further surgery was 3%. These data suggest minimal risk to the patient when the ovaries are conserved. Unfortunately, lateral ovarian transposition preserves ovarian function in only 50% of patients undergoing pelvic radiotherapy following radical hysterectomy.
authors: Department of Obstetrics and Gynecology, Indiana University Medical Center, Indianapolis 46202-5274.
authors: D D
authors: DD
authors: Feeney
authors: D H
authors: DH
authors: Moore
authors: K Y
authors: KY
authors: Look
authors: F B
authors: FB
authors: Stehman
authors: G P
authors: GP
authors: Sutton
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008197:Lymph Node Excision; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D010048:Ovarian Cysts / Q000209:etiology; D010049:Ovarian Diseases / Q000209:etiology; D010053:Ovary / Q000502:physiology*; D014102:Torsion Abnormality; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery*
chemical_list: D005640:Follicle Stimulating Hormone