Persistent posttrachelectomy cervical stenosis treated with Petit-Le Four pessary in early cervical cancer patients: a report of two cases

Fertil Steril. 2007 Dec;88(6):1677.e5-7. doi: 10.1016/j.fertnstert.2007.01.047. Epub 2007 May 4.

Abstract

Objective: To report on posttrachelectomy refractory cervical stenosis in two women with early cervical cancer that was resolved by using a Petit-Le Four tube, an older type of cervical pessary.

Design: Case report.

Setting: Tertiary care, university hospital.

Patient(s): Two young women with FIGO stage IB1 cervical cancer and posttrachelectomy cervical stenosis.

Intervention(s): Cervical dilatations and Petit-Le Four cervical pessary insertion.

Main outcome measure(s): Treatment of hematometra, pelvic pain, and infertility.

Result(s): The Petit-Le Four cervical pessary is a good therapeutic option for the treatment of cervical stenosis after trachelectomy performed for early cervical cancer.

Conclusion(s): Persistent hematometra from cervical stenosis could compromise both fertility and quality of life, and often requires dilatation of the cervical ostium, which must be performed several times in the same patient to obtain optimal results. Cervical dilators left in place could help physicians in the treatment of recurrent cervical stenosis after trachelectomy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Female
  • Fertilization in Vitro
  • Humans
  • Intrauterine Devices*
  • Postoperative Complications / therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Recurrence
  • Uterine Cervical Diseases / etiology
  • Uterine Cervical Diseases / therapy*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*