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.