What is your approach to uterine perforation during the time of brachytherapy implant for cervical cancer?   

First off, I think uterine perforations occur a lot more frequently and easily than we previously accounted for. I learned how to perform brachytherapy using purely orthogonal X-rays, with dosing and dwell position times based on measured distances from the applicators, and all of the focus was pla...

I agree with most of @Jonathan Feddock's comments. The most important point is that a tandem should never be loaded if any portion of it is in the peritoneal cavity. A loaded tandem in the peritoneal cavity will almost always lead to a bowel perforation, which is frequently fatal. There are many tr...