46-year-old woman

30-week size fibroid uterus not desiring fertility.

Symptoms

Heavy, irregular vaginal bleeding
Increased urinary frequency
Abdominal distension
Pelvic pain

Ultrasound

30+ cm uterus with multiple fibroids

Examination

30+ week size fibroid uterus

Recommendations

Expectant management (no treatment), myomectomy, supracervical hysterectomy (SCH).

Treatment

She received Lupron pre-op to shrink uterus and increase hemoglobin. Patient underwent uncomplicated supracervical hysterectomy (SCH) through mini-laparotomy incision. Multiple fibroids removed to debulk uterus prior to removing uterus. Minimal blood loss. Patient discharged on post-op day #1.