42-year-old woman
16-week-size fibroid uterus not desiring fertility.
Symptoms
- Heavy, irregular vaginal bleeding
- Increased urinary frequency
- Pelvic pain
Prior treatments
Failed treatment with Mirena IUD and oral contraceptive pills (OCPs)
Ultrasound
10 cm central fibroid
Examination
16-week-size fibroid uterus
Recommendations
Expectant management (no treatment), Uterine Fibroid Embolization (UFE), myomectomy, supracervical hysterectomy (SCH).
Treatment
Patient underwent uncomplicated supracervical hysterectomy (SCH) through mini-laparotomy incision. Large central fibroid removed to debulk uterus prior to removing uterus. Minimal blood loss. Patient discharged on post-op day #1.
Large central fibroid delivered through mini-lap incision to debulk uterus
Large central fibroid separated from uterus
Uterine corpus (body) being amputated from cervix
Uterine corpus (body) being amputated from cervix
Cervical stump cauterized to decreases risk of future cyclical bleeding
Mini-lap incision
Mini-lap incision closed with sub-cutaneous stitch
Surgical specimens, fibroid and uterus