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.
Goldberg morcellation technique to remove fibroids through mini-laparotomy incision
Repaired uterus following myomectomy
Fibroids removed