scholarly journals Imaging of Subcutaneous Ovarian Transposition and Its Rare Complications—A Pictorial Assay

2021 ◽  
Author(s):  
Thara Pratap ◽  
K. Chithratara ◽  
Muhammed Jasim Abdul Jalal ◽  
Dhanya Jacob ◽  
A.K. Vishnu
Keyword(s):  
Cervical Cancer ◽  
Ovarian Function ◽  
Premenopausal Women ◽  
Ct Imaging ◽  
Imaging Findings ◽  
Common Indication ◽  
Anatomical Position ◽  
Ovarian Transposition ◽  
Early Cervical Cancer ◽  
Normal Ultrasound

AbstractOvarian transposition, as the name implies, is transpositioning the ovary from its normal anatomical position to another location. This procedure is usually done to preserve the ovarian function. The most common indication of ovarian transposition is early cervical cancer in young premenopausal women to preserve fertility. Subcutaneous ovarian transposition can also be done for benign conditions such as adenomyosis and severe endometriosis in young premenopausal women. We discuss our experience with ovarian transposition in 9 cases, normal ultrasound and CT imaging findings in transposed ovaries, and rare complications which occurred in 2 cases.

Correlation Between Location of Transposed Ovary and Function in Cervical Cancer Patients Who Underwent Radical Hysterectomy

2015 ◽  
Vol 25 (4) ◽  
pp. 688-693 ◽  
Author(s):  
Aera Yoon ◽  
Yoo-Young Lee ◽  
Won Park ◽  
Seung Jae Huh ◽  
Chel Hun Choi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Ovarian Function ◽  
Medical Center ◽  
Young Patients ◽  
Surrogate Marker ◽  
Ovarian Transposition ◽  
Median Serum ◽  
Early Cervical Cancer ◽  
And Function

ObjectiveThe study investigated the association between the location of transposed ovaries and posttreatment ovarian function in patients with early cervical cancer (IB1-IIA) who underwent radical hysterectomy and ovarian transposition with or without adjuvant therapies.MethodsRetrospective medical records were reviewed to enroll the patients with early cervical cancer who underwent ovarian transposition during radical hysterectomy at Samsung Medical Center between July 1995 and July 2012. Serum follicle-stimulating hormone (FSH) level was used as a surrogate marker for ovarian function.ResultsTwenty-one patients were enrolled. The median age and body mass index (BMI) were 31 years (range, 24–39 years) and 21.3 kg/m2 (range, 17.7–31.2 kg/m2), respectively. The median serum FSH level after treatment was 7.9 mIU/mL (range, 2.4–143.4 mIU/mL). The median distance from the iliac crest to transposed ovaries on erect plain abdominal x-ray was 0.5 cm (range, −2.7 to 5.2 cm). In multivariate analysis, posttreatment serum FSH levels were significantly associated with the location of transposed ovaries (β = −8.1, P = 0.032), concurrent chemoradiation (CCRT) as an adjuvant therapy (β = 71.08, P = 0.006), and BMI before treatment (underweight: β = −59.93, P = 0.05; overweight: β = −40.62, P = 0.041).ConclusionsLocation of transposed ovaries, adjuvant CCRT, and BMI before treatment may be associated with ovarian function after treatment. We suggest that ovaries should be transposed as highly as possible during radical hysterectomy to preserve ovarian function in young patients with early cervical cancer who might be a candidate for adjuvant CCRT and who have low BMI before treatment.

Laparoscopic ovarian transposition in patients with early cervical cancer

2008 ◽  
Vol 18 (3) ◽  
pp. 584-589 ◽  
Author(s):  
J. PAHISA ◽  
S. MARTÍNEZ-ROMÁN ◽  
M. A. MARTÍNEZ-ZAMORA ◽  
A. TORNÉ ◽  
X. CAPARRÓS ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Ovarian Function ◽  
Young Patients ◽  
Figo Stage ◽  
Pelvic Radiotherapy ◽  
Ovarian Transposition ◽  
Hormonal Function ◽  
Pathologic Evaluation ◽  
Minimum Delay ◽  
Early Cervical Cancer

The aim of this study was to evaluate the feasibility, efficacy, and morbidity of laparoscopic ovarian transposition on the preservation of hormonal function in patients younger than 45 years operated for early cervical cancer. According to risk factors on pathologic evaluation of the specimen, some of them will receive postoperative pelvic radiotherapy. This subset of patients could benefit from taking the ovaries away from the irradiation field in an effort to preserve their functionality. This prospective study included 28 FIGO stage IB1 cervical cancer patients, 45 years old or younger, maintaining menstrual cycles, who were considered suitable for conservation of the ovaries. The ovarian transposition was performed by laparoscopy as a part of the same celio-Schauta operation. Twelve patients underwent adjuvant pelvic radiotherapy. No intraoperative or postoperative morbidity related to the ovarian transposition was observed, and the procedure only entailed a minimum delay of the operative time. There were no cases of ovarian metastasis. At a mean follow-up of 44 months, 63.6% of patients receiving radiotherapy and 93% of those who nonirradiated maintained normal ovarian function. Two patients developed benign ovarian cysts, requiring oophorectomy, but no other long-term adverse effects of the transposition were identified. To the best of our knowledge, this is the largest series of the laparoscopic procedure reported to date in this setting. According to our results, laparoscopic ovarian transposition is a safe and effective procedure for the preservation of ovarian function in young patients with early cervical cancer undergoing adjuvant radiotherapy after surgery

scholarly journals Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiao-juan Lv ◽  
Xiao-long Cheng ◽  
Ye-qiang Tu ◽  
Ding-ding Yan ◽  
Qiu Tang
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Iliac Crest ◽  
Ovarian Function ◽  
Pelvic Radiotherapy ◽  
Cutoff Value ◽  
Ovarian Transposition ◽  
Transverse Distance ◽  
Upper Boundary

Abstract Background and purpose How to protect the ovarian function during radiotherapy is uncertain. The purpose of this study was to explore the association between the location of the transposed ovary and the ovarian dose in patients with cervical cancer received radical hysterectomy, ovarian transposition, and postoperative pelvic radiotherapy. Methods A retrospective analysis was conducted of 150 young patients with cervical cancer who received radical hysterectomy, intraoperative ovarian transposition, and postoperative adjuvant radiotherapy in Zhejiang Cancer Hospital. Association between location of the transposed ovaries and ovarian dose was evaluated. The transposed position of ovaries with a satisfactory dose was explored using a receiver operator characteristic curve (ROC) analysis. Patients’ ovarian function was followed up 3 months and 1 year after radiotherapy. Results A total of 32/214 (15%) transposed ovaries were higher than the upper boundary of the planning target volume (PTV). The optimum cutoff value of > 1.12 cm above the iliac crest plane was significantly associated with ovaries above the upper PTV boundary. When the ovaries were below the upper boundary of PTV, the optimum cutoff value of transverse distance > 3.265 cm between the ovary and PTV was significantly associated with ovarian max dose (Dmax) ≤ 4Gy, and the optimum cutoff value of transverse distance > 2.391 cm was significantly associated with ovarian Dmax≤5Gy. A total of 77 patients had received complete follow-up, and 56 patients (72.7%) showed preserved ovarian function 1 year after radiotherapy, which was significantly increased compared with 3 months (44.2%) after radiotherapy. Conclusions The location of transposed ovaries in patients with cervical cancer is significantly correlated with ovarian dose in adjuvant radiotherapy. We recommend transposition of ovaries > 1.12 cm higher than the iliac crest plane to obtain ovarian location above PTV. When the transposed ovary is below the upper boundary of PTV, ovarian Dmax ≤4Gy may be obtained when the transverse distance between the ovary and PTV was > 3.265 cm, and the ovarian Dmax≤5Gy may be obtained when the transverse distance was > 2.391 cm.

Laparoscopic ovarian transposition in patients with pelvic cancer

2014 ◽  
Vol 20 (4) ◽  
pp. 207-212
Author(s):  
Kastytis Žilinskas ◽  
Živilė Sabonytė-Balšaitienė ◽  
Narimantas Evaldas Samalavičius
Keyword(s):  
Rectal Cancer ◽  
Ovarian Function ◽  
Vena Cava ◽  
Premenopausal Women ◽  
Tumor Stage ◽  
Reproductive Age ◽  
Stage Iii ◽  
Ovarian Transposition ◽  
Hospitalization Period ◽  
Pelvic Cancer

Background. The aim of this study was to evaluate the feasibility of laparoscopic ovarian transposition prior to radiation therapy on the preservation of hormonal function in the treatment of pelvic cancer. Materials and methods. A chart review of premenopausal women diag­nosed with pelvic cancer, who underwent laparoscopic ovarian transposition to paracolic gutters, then received preoperative radiotherapy at the Center of Oncosurgery, Oncology Institute of Vilnius, from January 2010 to July 2013. Results. A total of 14 patients underwent laparoscopic ovarian transposition. Patients were divided into two groups by localisation of can­cer: 2 (14.29%) patients diagnosed with rectal cancer and 12 (85.71%) with cervical cancer. Patients’ age was from 24 to 42  years with a mean age of 33.71 (SD  ±  5.22) years. The average age of the patients in the first group was 26 (SD ±  2.83) years. In the second group women, aged 29 and 42 years with a mean age of 35 (SD ± 4.35) years, were analyzed. Rectal cancer of stage III was diagnosed in both women of the first group. Tumor stage distribution in the second group, respectively: stage I  –  2  cases (16.67%), stage  II  –  3  cases (25%), stage  III  –  7 cases (58.33%). Seven (58.33%) patients of the second group underwent complete endoscopic staging. In these groups of 14 patients there were 2 (14.3%) complications (injury of the inferior vena cava and postoperative abnormal vaginal bleeding). No postoperative exitus occurred. The mean duration of the operation was 2 hours 26 minutes ± 55 minutes (60–245 minutes), respectively, 2  hours 40  minutes  ±  49  minutes (95–245  minutes) when laparoscopic staging and ovarian transposition was performed and 2  hours 12  minutes  ±  1  hour 1  minute (60–245  minutes) when only ovarian transposition was performed. The hospitalization period ranged from 5 to 52 days (average 12 days). Conclusions. Laparoscopic ovarian transposition is a relatively safe and effective procedure for preserving ovarian function. This procedure should be considered in all reproductive age female patients who need to undergo pelvic irradiation as part of pelvic cancer treatment.

Laparoscopic Ovarian Transposition Before Pelvic Irradiation: A Saudi Tertiary Center Experience

2010 ◽  
Vol 20 (6) ◽  
pp. 1082-1086 ◽  
Author(s):  
Ismail A. Al-Badawi ◽  
Murad Al-Aker ◽  
Jamal AlSubhi ◽  
Hany Salem ◽  
Alaa Abduljabbar ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Medical Center ◽  
Gynecologic Oncology ◽  
Follicle Stimulating Hormone ◽  
Premenopausal Women ◽  
Pelvic Irradiation ◽  
Ovarian Transposition ◽  
Tertiary Center ◽  
Stimulating Hormone

Objective:To report the authors' experience with laparoscopic ovarian transposition and ovarian function preservation in women who require pelvic irradiation as part of their cancer therapy.Design:Cohort study.Setting:The gynecologic oncology service in a referral tertiary/quaternary medical center in Saudi Arabia.Patients:Twenty-three premenopausal patients treated with radiotherapy for a pelvic malignancy.Interventions:Laparoscopic ovarian transposition to paracolic gutters with uterine conservation.Main Outcome Measures:Preservation of ovarian function assessed by patients' symptoms and serum follicle-stimulating hormone level.Results:Bilateral laparoscopic ovarian transposition was performed in 23 patients: 15 with cervical cancer, 4 with rectal cancer, 3 with Ewing sarcoma, and 1 with Hodgkin lymphoma. No immediate intraoperative or postoperative complications were observed. Three patients were lost to follow-up. Ovarian preservation was achieved in 13 (65%) of 20 patients. Seven patients with low follicle-stimulating hormone levels had regular uterine bleeding at follow-up.Conclusions:Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. This procedure should be considered in all premenopausal women who need to undergo pelvic irradiation as part of their cancer treatment.

scholarly journals Ovarian Function Preservation in Patients With Cervical Cancer Undergoing Hysterectomy and Ovarian Transposition Before Pelvic Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110421
Author(s):  
Wonguen Jung ◽  
Yun H. Kim ◽  
Kyung S. Kim
Keyword(s):  
Cervical Cancer ◽  
Ovarian Function ◽  
External Beam Radiotherapy ◽  
Intraepithelial Neoplasia ◽  
Ovarian Failure ◽  
P Value ◽  
Ovarian Transposition ◽  
Group 4 ◽  
Function Preservation ◽  
Group 2

To examine the factors associated with ovarian failure (OF) and assess the effectiveness of ovarian transposition (OT) before pelvic irradiation for preserving ovarian function in patients with cervical cancer (CC) undergoing hysterectomy. During 2003 to 2017, patients who underwent hysterectomy with preservation of one or both ovaries were retrospectively enrolled. Patients were divided into 4 groups, depending on whether radiotherapy (RT) and OT were performed: group 1, RT(+) and OT(+); group 2, RT(+) and OT(−); group 3, RT(−) and OT(+); group 4, RT(−) and OT(−). OF was defined as serum follicle-stimulating hormone levels of ≥30 mIU/mL. Sixty-six patients (59 [89.4%] invasive CC and 7 [10.6%] cervical intraepithelial neoplasia) were included. The 2-year OF-free survival rate was 61.4% (95% confidence interval [CI] 37.8-86.0), 0%, 91.7% (95% CI 76.0-100), and 75.8% (95% CI 58.2-93.4) for groups 1, 2, 3, and 4, respectively. In groups 1 and 2 receiving RT, OT, and combination of external beam radiotherapy and vaginal brachytherapy were associated with OF on multivariate analysis (MVA) ( P-value  =  .002 and .046, respectively). In groups 3 and 4 without RT, older age (40 years old) and OT did not affect OF; however, the number of remaining ovaries was independently associated with OF in MVA ( P  =  .035). OT could effectively preserve ovarian function in patients treated with adjuvant RT, while OT procedure itself did not affect ovarian failure. OT should be considered in the management of premenopausal cervical cancer patients.

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