Fertility-sparing surgery for symptomatic uterine fibroid in young women: a case report

Abstract

Uterine leiomyoma is very common tumor in women of reproductive age. Clinical manifestation ranges from asymptomatic to very heavy bothersome menstrual bleeding or dysmenorrhoea. Considering the patient age, severity of symptoms and child bearing medical or conservative surgical or hysterectomy is decided. Herer we are presenting a case of A 27 years old Para2 housewife coming from middle socioeconomic status was admitted with history of chronic lower abdominal pain since last 5 years and heavy menstrual bleeding since last 6months. Her period was regular but associated with pain and heavy bleeding. She was normotensive and pulse was 78/min. mild pallor present clinically. On abdominal examination-there is lower abdominal swelling situated in midline almost globular, firm to hard in consistency margins are well defined except lower margins which could not be reached, surface smooth and dull on percussion. Vaginal examination revealed vulva normal, vagina and cervix looks healthy on speculum examination. Bimanual examination shows pelvi-abdominal large mass seem to be arisen from uterus. Both fornices are free. After complete routine and ultrasound evaluation a diagnosis of anterior intramural fibroid was made. As patient wants her fertility to be preserved so decision of open myomectomy was taken. Myoma was removed completely with capsule and without interfering the uterine cavity. Uterine incision was closed. Patient stood well with procedure and discharged form hospital.