A new approach to preserve fertility by using a coated nitinol stent in a patient with recurrent cervical stenosis

Objective: The incidence of hematometra caused by cervical stenosis after conization is <1%. Nevertheless, if dilatation was unsuccessful, further therapy often remains unclear, and the clinical consequences can be severe, including hysterectomy. Design: Case report. Setting: University hospital. Patient(s): A 33-year old patient who developed recurrent cervical stenosis with consecutive hematometra after two conizations during lactation amenorrhea that could not be treated by dilatation and insertion of a temporary plastic catheter according to the manufacturer's instructions. Intervention(s): Insertion of a coated nitinol stent in the cervical canal after dilatation and hysteroscopic removal of the hematometra. Main Outcome Measure(s): Normal menstruation, future pregnancy. Result(s): The patient was free of symptoms, had a normal menstruation, and has become pregnant. Conclusion(s): The insertion of a coated vessel stent in the uterine cervix appears to be a valid alternative in patients with recurrent cervical stenosis and hematometra after conization to preserve childbearing function. (Fertil Steril (R) 2007;87:1212.e13-16. (C) 2007 by American Society for Reproductive Medicine.)