THE FATE OF THE OVARIES AFTER RADICAL HYSTERECTOMY AND OVARIAN TRANSPOSITION

To assess the effectiveness of lateral ovarian transposition in preser ving normal ovarian function, the medical records of 200 consecutive w omen with stage I-IIA cervical cancer treated primarily with radical h ysterectomy 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 t herapy. Menopausal symptoms (vaginal dryness, hot flushes) and follicl e-stimulating hormone (FSH) levels were used to define ovarian functio n. Only 3/104 (2.9%) patients who underwent lateral ovarian transposit ion without postoperative pelvic radiotherapy experienced menopausal s ymptoms; however, FSH levels in all three cases suggested continued ov arian function. In 14/28 (50%) patients who received postoperative pel vic radiation therapy ovarian failure occurred. The risk of ovarian fa ilure with pelvic radiation therapy after lateral ovarian transpositio n was significant (RR = 17.3; 95% CI = 5.35-56.13). The incidence of a dnexal disease in transposed ovaries requiring analgesics or further s urgery was 3%. These data suggest minimal risk to the patient when the ovaries are conserved. Unfortunately, lateral ovarian transposition p reserves ovarian function in only 50% of patients undergoing pelvic ra diotherapy following radical hysterectomy. (C) 1995 Academic Press, In c.