Aim: To evaluate and identify the risk factors for abnormal menstruation after radical trachelectomy. Methods: This study included 58 patients who underwent radical trachelectomy at our hospital between April 2005 and January 2018. Patients were divided into groups of those with no change in postoperative menstruation (regular [R] group; n = 46) and those with abnormal menstruation such as amenorrhea or hypomenorrhea (irregular [I] group; n = 12). The perioperative characteristics and fertility of the groups were compared retrospectively. The data were statistically analyzed using Student's t-test, Fisher's exact test and Mann-Whitney U test for univariate analysis and logistic regression analysis for multivariate analysis, with the level of statistical significance set at P < 0.05. Results: Based on Federation of Gynecology and Obstetrics staging, 54 patients had stage IB1, 2 had stage IB2 and 2 had stage IIA1 cervical cancer. Eight patients received neoadjuvant chemotherapy. Pretreatment tumor size, residual uterine cavity length and neoadjuvant and postoperative chemotherapy use were not significantly different between the groups. Abnormal menstruation was significantly more common in patients with postoperative pelvic infection (R group, 13.0%; I group, 58.3%) and cervical stenosis (R group, 15.2%; I group, 58.3%). Conclusion: To maintain healthy menstruation even after radical trachelectomy, it is important to prevent postoperative pelvic infection and cervical stenosis.

HighlightsLaparoscopy is useful for the observation and treatment of vaginal cuff dehiscence.This case highlights the merits of both laparoscopy and transvaginal cuff suturing.Peritonitis and abdominal adhesion must be considered in vaginal cuff evisceration.

HighlightsVaginal cancer is most common in elderly woman and very rare in young woman.Stage I vaginal cancer is treated with surgery and radiotherapy.Vaginal cancer in a young patient was treated by intra-arterial chemotherapy followed by abdominal radical trachelectomy.