35-year-old woman

16 week size fibroid uterus desiring fertility. History of a prior myomectomy.


Symptoms

  • Infertility
  • Increased urinary frequency
  • Pelvic pressure

Ultrasound

17 cm uterus with multiple fibroids, large lower uterine segment fibroid

Examination

14 week size fibroid uterus

Recommendations

Expectant management (no treatment) or myomectomy. Pre-op Lupron recommended to shrink the large lower uterine segment fibroid

Treatment

Patient underwent uncomplicated myomectomy through mini-laparotomy incision 3 months following Lupron injection. 6 fibroids removed. Adhesions of uterus to abdominal wall encountered and lysed. Minimal blood loss. Patient discharged on post-op day #1.