Follow-up after radical vaginal trachelectomy (RVT): patients' problems and physicians' difficulties

Arch Gynecol Obstet. 2017 Sep;296(3):559-564. doi: 10.1007/s00404-017-4463-0. Epub 2017 Jul 17.

Abstract

Purpose: Patients after radical vaginal trachelectomy (RVT) need specific follow-up treatment because their problems differ from those of other gyneco-oncologic patients. Anatomic changes after surgery complicate examinations. Recognition and treatment of these issues require physician's expertise.

Patients and methods: We evaluated the follow-up data of 70 patients who underwent RVT for early cervical cancer between 03/2010 and 12/2013. The follow-up interval in the first 2 years was 3 and 6 months in the following 2 years. We used a tailored protocol to describe the special problems after RVT.

Results: Cervical stenosis was one of the central problems independent of time interval to RVT. Physicians' most significant problem was to locate the exact position of the neo-cervix and thus to receive valid pap smears.

Conclusions: Follow-up of patients after RVT needs special expertise because the symptoms differ from those after hysterectomy and examinations ensuring oncologic safety require special attention.

Keywords: Cervical cancer; Cervical stenosis; Follow-up; Neo-cervix; Vaginal trachelectomy.

MeSH terms

  • Cervix Uteri / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Postoperative Complications*
  • Trachelectomy / adverse effects*
  • Trachelectomy / methods*
  • Uterine Cervical Neoplasms / surgery
  • Vagina / surgery*