Objective: Lymph node recurrence is extremely rare in cases of stage IA1 squamous cell carcinoma (SCC) of the uterine cervix without lymphovascular space invasion (LVSI). We present two cases of extraregional lymph node recurrence after initial surgery for stage IA1 SCC of the uterine cervix without LVSI. Patients: Both patients initially underwent hysterectomy and developed recurrent extraregional lymph nodes within a few years postoperatively. Case 1: The patient showed no symptoms of recurrence, and follow-up computed tomography (CT) for evaluation of gallstones revealed a para-aortic lymph node (9 mm). The patient subsequently underwent serum SCC antigen testing and CT and was diagnosed with recurrence. Case 2: The patient noticed a right inguinal node swelling, which was evaluated using CT. Both patients survived without relapse for 8 and 4 years, respectively. Conclusion: Although stage IA1 SCC of the uterine cervix without LVSI is associated with a low risk of lymph node recurrence, oncologists should consider the possibility of recurrence in such cases. Evaluation for recurrence is difficult in asymptomatic patients. Serum SCC antigen testing may be a useful biochemical marker before imaging for early detection of recurrence, even in asymptomatic patients.

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Main Results: The mean age of the women in this study was 36.5 ± 4.2 years and 163 (81.9%) were nulliparous. Malignancy was detected postoperatively in 5 of the 199 (2.5%) women. One woman underwent an additional operation, whereas the other 4 received medroxyprogesterone acetate and continued with treatment for infertility. Notably, 70 of 122 (57.4%) women successfully conceived within a year of surgery; however, among these 70, miscarriage occurred in 10 women. Detailed obstetric data were available for 46 women with live births following surgery. Among these 46 women, 19 underwent a cesarean section. No detrimental effects were observed on reproductive and obstetric outcomes. Conclusions: Hysteroscopic surgery was safely and effectively performed in women with infertility admitted to our hospital. Hysteroscopic surgery may contribute to successful treatment of infertility in women with intrauterine lesions.

Background Parasitic myoma is an extrauterine leiomyoma that develops because of feeding of nutrients by vessels from organs other than those of the uterus. Recently, laparoscopic myomectomy has become popular. However, incidences of iatrogenic parasitic myoma have also been reported. In this case, uterine myoma recurred after laparoscopic myomectomy and disseminated lesions were found in the peritoneal cavity with suspected uterine sarcoma.

Objective: Previous studies have reported an increased risk of vaginal cuff dehiscence following total laparoscopic hysterectomy (TLH) compared with that following total abdominal hysterectomy or vaginal hysterectomy. Although vaginal cuff dehiscence after TLH is rare, it often results in severe complications, and although the cause remains unknown, the use of energy devices in vaginal incision has been implicated. This study investigated whether reducing coagulation hemostasis decreases the risk of vaginal cuff dehiscence. Methods: A total of 863 cases of TLH were analyzed from January 2016 to December 2017 at our hospital. We modified the method of hemostasis of vaginal cuff since January 2017. We followed different methods for hemostasis of the vaginal cuff between January and December 2016 (group A, complete hemostasis) and between January and December 2017 (group B, almost complete hemostasis, except in case of heavy hemorrhage). Group A included 352 cases, and group B included 511 cases. Vaginal dehiscence rates in the two groups were compared using the χ2 test. Results: Vaginal cuff dehiscence was observed in four cases (1.1%) in group A and two cases (0.3%) in group B, which showed drastic reduction. However, no significant difference (p=0.2) was noted. Sexual intercourse was found to be the biggest trigger for the complication (50%). Conclusions: Based on our results, we recommend that decreasing the vaginal cuff coagulation hemostasis can reduce vaginal cuff dehiscence following TLH.