Uterine transposition: technique and a case report

Abstract

Objective: To report the first uterine transposition for fertility preservation in a patient with rectal cancer.

Design: Case report.

Setting: Community hospital.

Patient(s): A 26-year-old patient with stage cT3N1M0 rectal adenocarcinoma located 5 cm from the anal margin.

Intervention(s): Laparoscopic transposition of the uterus to the upper abdomen, outside of the scope of radiation, was performed to preserve fertility. After the end of radiotherapy, rectosigmoidectomy was performed and the uterus was repositioned into the pelvis.

Main outcome measure(s): Uterine and ovarian function preservation.

Result(s): The patient had two menstrual periods and exhibited normal variation in ovarian hormones throughout the course of neoadjuvant therapy. Menstruation began 2 weeks after reimplantation into the pelvis, and the cervix exhibited a normal appearance on clinical examination after 6 weeks. Eighteen months after the surgery, the uterus was normal and there was no sign of disease.

Conclusion(s): Uterine transposition might represent a valid option for fertility preservation in women who require pelvic radiotherapy and want to bear children. However, studies that assess its viability, effectiveness, and safety are required.

Keywords: Uterine transposition; fertility preservation; laparoscopy; pelvic radiotherapy; rectal cancer.