Traditionally radical hysterectomy has formed the mainstay of treatment for early stage cervical carcinoma. More recently radical trachelectomy and laparoscopic lymphadenectomy have been introduced to allow preservation of fertility. We present a new approach to fertility-sparing surgery, namely abdominal radical trachelectomy. The technique is similar to a standard radical hysterectomy and lymphadenectomy. In our technique the ovarian vessels are not ligated and, following lymphadenectomy and skeletonisation of the uterine arteries, the cervix, parametrium and vaginal cuff are excised. The residuum of the cervix is then sutured to the vagina and the uterine ateries reanastomosed.Traditionally the treatment for invasive cervical carcinoma which has progressed beyond microinvasion has been radical hysterectomy. Long term experience of radical surgery for Stage l b carcinoma has shown that it produces excellent results in terms of survival but that morbidity may be significant, and there is always loss of potential for future childbearing. Increasingly, large numbers of young women (24-35 years) are being diagnosed with cervical cancer1. Clearly, the loss of fertility in these women can be devastating.In recent years there has been a move towards more conservative approaches for the treatment of cervical carcinoma. Conisation of the cervix has become acceptable practice for the management of FIG0 classification Stage la(i) tumours. In an attempt to develop a more conservative operation for early invasive carcinoma of the cervix, Dargent et al.* described a new technique suitable for exophytic tumours of Stages l a to 2a which allowed preservation of the uterus but removed the cervix, parametrium and upper one third of the vagina.He called this procedure 'radical trachelectomy '. His patients also underwent laparoscopic pelvic lymphadenectomy, with negative histology results. The

Previous research has produced conflicting results regarding the association of bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN). These studies have been weakened in their conclusions mainly by failure to adequately control for the presence of sexually transmitted infections (STIs). One proposed mechanism suggesting that carcinogenic nitrosamines acting either independently or via human papilloma virus (HPV) has not been fully tested previously. We undertook a prospective, case-controlled, cross-sectional study where the presence of STIs, in particular human papillomavirus (HPV) which is known to be associated with the development of CIN, was controlled for. Women with BV were not found to have CIN more frequently than women with normal vaginal flora and the quantities of nitrosamines produced by women with BV did not differ significantly from women without BV. We thus found that BV is not associated with CIN.

Previous research has produced conflicting results regarding the association of bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN). These studies have been weakened in their conclusions mainly by failure to adequately control for the presence of sexually transmitted infections (STIs). One proposed mechanism suggesting that carcinogenic nitrosamines acting either independently or via human papilloma virus (HPV) has not been fully tested previously. We undertook a prospective, case-controlled, cross-sectional study where the presence of STIs, in particular human papillomavirus (HPV) which is known to be associated with the development of CIN, was controlled for. Women with BV were not found to have CIN more frequently than women with normal vaginal flora and the quantities of nitrosamines produced by women with BV did not differ significantly from women without BV. We thus found that BV is not associated with CIN.