Successful removal of 34 fibroids in uterus-preserving myomectomy: a case report
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221457Keywords:
Myoma, Myomectomy, Hystero-laparoscopy, FibroidAbstract
When uterine preservation is of the essence, myomectomy is the preferred standard of surgical care for removal of myomas, the commonest tumors of the female genital tract. This case report describes the evaluation and treatment of a 42-year-old female with a multi-fibroid uterus, who desired uterine preservation in order to conceive. Diagnostic hystero-laparoscopy with myomectomy resulted in the removal of 34 leiomyomas of varying sizes from different locations within the uterus. Our case study is of particular importance as it emphasizes that effective removal of even a large number of multiple fibroids is attainable in rural, low-resource settings by strict adherence to the established myomectomy protocol and the achievement of as bloodless an operative field as possible using various available techniques.
References
Machupalli S, Norkus EP, Mukherjee TK, Reilly KD. Abdominal Myomectomy Increases Fertility Outcome. Gynecol Obstet. 2013;3:144.
Chen I, Lisonkova S, Joseph KS, Williams C, Yong P. Laparoscopic versus abdominal myomectomy: practice patterns and health care use in British Columbia. J Obstet Gynaecol Can. 2014;36:817-21.
Kumura DS, Siarezi S. A Case of a Prolapsed Fibroid in a 12-Year-Old. Journal of Pediatric and Adolescent Gynecology. 2019;34:17-20.
Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. International Journal of Women’s Health. 2014;6(1):95-114.
Kayadibi Y, Ozmen E, Emir H, Emre S, Dervisoglu S, Adaletli I. Subserosal leiomyoma of uterus mimicking an ovarian tumour in adolescent patient. Japanese Journal of Radiology. 2013;32(1):48-52.
Chen I, Lisonkova S, Joseph KS, Williams C, Yong P. Laparoscopic versus abdominal myomectomy: practice patterns and health care use in British Columbia. J Obstet Gynaecol Can. 2014;36:817-21.
Taylor A, Sharma M, Tsirkas P, Di Spiezio Sardo A, Setchell M. Reducing blood loss at open myomectomy using triple tourniquets: A randomised controlled trial. BJOG. 2005;112:340-5.
Van den Bosch T. Benign disease of the uterus. In: Edmomds DK, Lees C, Bourn T, eds. Dewhurst’s Textbook of Obstetrics and Gynaecology, 9th edition. Oxford; Wiley-Blackwell Publishing Inc.
Kwawukume EY, Ekele BA, Danso KA, Emuveyan EE. Editors. Comprehensive Gynaecology in the Tropics. Accra: G-pak Limited. 2017;173-86.
Garba I, Ayyuba R, Adewale TM, Abubakar IS. Surgical management of uterine fibroids at Aminu Kano Teaching Hospital. Niger J Basic Clin Sci. 2016;13(1):50-4.
Bizjak T, Bečić A, But I. Prevalence and Risk Factors of Uterine Fibroids in North-East Slovenia. Gynecol Obstet (Sunnyvale). 2016;6:350.
Stewart EA. Overview of treatment of uterine leiomyomas (fibroids). Up-to-date, version. 2012;20.3.
Kunde K, Cortes E, Seed P, Khalaf Y. Evaluation of perioperative morbidity associated with single and multiple myomectomy. J Obstet Gynaecol. 2009;29:737-41.
Mettler L, Schollmeyer T, Tinelli A, Malvasi A, Alkatout I. Complications of Uterine Fibroids and Their Management, Surgical Management of Fibroids, Laparoscopy and Hysteroscopy versus Hysterectomy, Haemorrhage, Adhesions, and Complications. Obstetrics and Gynecology International. 2012;20:430-4.
Chapron C, Fauconnier A, Goffinet F, Bréart G, Dubuisson JB. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a meta-analysis. Human Reproduction. 2002;17:1334-42.
Kathpalia S. A Case Report of Multiple Myomectomies. Juniper Online Journal of Case Studies. 2018;6(2).
Holden L. Successful uterine-sparing surgical management in a patient with a large multi-fibroid uterus. Journal of Surgical Case Reports. 2021;(6).
Leanza V. Surgical removal of multiple mesenteric fibroids (Kg 4,500) by abdominal spread of previous laparoscopic uterine myomectomy. Giornale di Chirurgia - Journal of Surgery. 2015;(6).
Ernest A, Mwakalebela A, Mpondo B. Uterine leiomyoma in a 19-year-old girl: Case report and literature review. Malawi Medical Journal. 2016;28(1):31.