Radical Trachelectomy (Fertility-Sparing Cervical Cancer Surgery)

Radical trachelectomy removes the cervix, the upper part of the vagina and the tissue beside the cervix, together with the pelvic lymph nodes, but leaves the body of the womb in place. The womb is then joined to the vagina, usually with a permanent stitch to hold it closed during a future pregnancy.

It treats selected early cervical cancers with cure rates similar to radical hysterectomy while keeping the possibility of pregnancy. It is only safe for small tumours, and pregnancies afterwards carry a higher risk of late miscarriage and premature birth.

What Radical Trachelectomy (Fertility-Sparing Cervical Cancer Surgery) involves

Staging comes first: a pelvic MRI to measure the tumour and its distance from the top of the cervix, a review of the biopsy and often a PET-CT. At surgery the pelvic lymph nodes, or sentinel nodes, are removed first and may be examined straight away; if cancer is found in them, the plan usually changes to chemoradiotherapy. If they are clear, the surgeon frees the cervix from the bladder and ureters, divides it about 1 cm below the junction with the womb, and sends the cut edge for immediate pathology to confirm a clear margin. A strong stitch (cerclage) is tied around the remaining isthmus, and the womb is sewn to the vagina.

Who is a good candidate for Radical Trachelectomy (Fertility-Sparing Cervical Cancer Surgery)?

Offered only after a gynaecological oncology team has reviewed the imaging and pathology.

• Stage IA1 with vessel invasion, IA2 or IB1 cancer, generally 2 cm or smaller
• Squamous, adenocarcinoma or adenosquamous type
• A definite wish to keep fertility, usually under about 40 to 45 years of age
• MRI showing enough healthy tissue between tumour and womb, and no suspicious nodes

It is usually not the right choice if:

• Tumours larger than 2 cm, for most approaches
• Neuroendocrine or other aggressive cell types
• Spread to lymph nodes or beyond the cervix
• Women who have completed their family, for whom hysterectomy is simpler and well proven
• Those with little realistic chance of conceiving for other reasons

Technique options

• Vaginal radical trachelectomy with laparoscopic nodes: The original technique. Less tissue beside the cervix is removed; suited to the smallest tumours.
• Abdominal radical trachelectomy: Open surgery allowing wider removal. Sometimes chosen for tumours approaching 2 cm, and the approach many guidelines now favour.
• Minimally invasive (laparoscopic or robotic): Offered in some centres. Discuss the evidence, since minimally invasive radical hysterectomy showed worse survival in a major trial.
• Simple trachelectomy or large cone biopsy: For very low-risk tumours, a smaller operation may be enough.

What happens during your treatment

The operation lasts 3 to 5 hours under general anaesthetic. You will have a urinary catheter for several days because the bladder nerves are disturbed, and you stay in hospital for 3 to 5 nights.

Preparing for your trip

Plan for 2 to 3 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Most women need 4 to 6 weeks off work. Avoid intercourse and tampons for about 6 weeks. You are advised to wait 6 to 12 months before trying to conceive. Any later pregnancy is managed as high risk and delivered by caesarean section, because of the permanent stitch. Follow-up examinations, HPV tests and MRI continue for at least 5 years and should be arranged at home before you travel.

• Back to everyday activity: 4 to 6 weeks
• When results show: Final pathology in 1 to 2 weeks
• How long they last: Follow-up for at least 5 years

Safety, risks and revision policy

The risks combine those of radical pelvic surgery with specific effects on later pregnancy.

• Finding positive nodes or margins during surgery, requiring conversion to hysterectomy or chemoradiotherapy
• Bladder emptying problems for days to weeks
• Narrowing of the new cervical opening, causing painful periods or difficulty conceiving
• Lymphoedema of the legs or lymph fluid collections
• Injury to the ureter or bladder
• Second-trimester miscarriage and preterm birth in later pregnancies
• Cancer recurrence, in about 3 to 5 percent of carefully selected cases

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Radical Trachelectomy (Fertility-Sparing Cervical Cancer Surgery) in Türkiye

Clinic-Y does not publish a single price for Radical Trachelectomy (Fertility-Sparing Cervical Cancer Surgery), because the honest figure depends on your case. What moves it:

• Open, vaginal or robotic approach
• Frozen-section pathology during the operation
• MRI and PET-CT staging
• Length of stay and catheter care
• Any further treatment advised after final pathology

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions