30-year-old woman
Endometrial cavity distortion due to fibroid uterus desiring fertility.
Symptoms
- Infertility
- Heavy menses
- Increased urinary frequency
- Pelvic pressure
Ultrasound
Uterus with multiple fibroids, large fibroid compressing endometrial cavity
Examination
14-week-size fibroid uterus
Recommendations
Expectant management (no treatment) or myomectomy. Discussion of decreased pregnancy rate and increased miscarriage rate due to compression of endometrial cavity where embryo implants
Treatment
Patient underwent uncomplicated myomectomy through mini-laparotomy incision. Large central fibroid plus other smaller ones removed. Minimal blood loss. Patient advised that she will require cesarean deliveries in future due to incisions > 50% of myometrial wall thickness. Patient discharged on post-op day #1.
Goldberg morcellation technique to remove central potato sized fibroid distorting endometrial cavity through mini-laparotomy incision
Fibroids removed