FERTILITY PRESERVATION AND EARLY POSTOPERATIVE CHALLENGESIN MYOMECTOMY- CASE REPORT AND REVIEW OF THE LITERATURE

Denisa-Oana Balalau2, Romina-Marina Sima1,2, Liana Pleş1,2
1The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
2“St. John” Hospital, “Bucur Maternity”, Bucharest

Corresponding author: Romina Sima
Phone no. 0040741071243
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Myomas or fibroids represent the most frequent type of genital benign tumor in women. Abdominal myomectomy was developed in the early 1900s as a conservative treatment for women with uterine myomas. A 29-year-old woman was admitted in our clinic for menomethrorragia and lower abdominal pain. She had no obstetrical past regarding abortions or deliveries but she desired to obtain a pregnancy in the future. The clinical and ultrasound examination revealed an enlarged uterus of about 10/9 cm with a 8/7 cm fibroid involving the entire anterior wall. We decided to perform myomectomy. Laparotomy was the choice instead of laparoscopy, considering the size and localization of the myoma. We succeeded to remove the fibroid, control the bleeding and let the uterus in place. Postoperative the patient presented anemia with hemoglobin levels between 6-8 g/dl due to heavy intraoperative blood loss. She received blood products to correct the anemia. She was discharged 5 days after the surgery and made a check visit one month later. She had no complaints and there was no pathology according to her physical examination. We report the case of a young woman with uterine large intramyometrial fibroid. The challenge of this case was to preserve uterus and fertility after myomectomy in consideration of the heavy operative hemorrhage.

Keywords: intramyometrial fibroid, myomectomy, menomethrorragia, lower abdominal pain

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