Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size
Leiomyoma of the uterus, also called fibroids, are common in women. In this case report, we describe the case of a nulliparous woman with a large, prolapsed submucous uterine leiomyoma of 10 × 11 cm was vaginally impacted. The aim is to highlight the challenges in managing such uncommon clinical sce...
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| Format: | Article |
| Language: | English |
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Oman Medical Specialty Board
2019-11-01
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| Series: | Oman Medical Journal |
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| Online Access: | http://omjournal.org/articleDetails.aspx?coType=1&aId=2509 |
| _version_ | 1818251507025313792 |
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| author | Maryam Al-Shukri Wadha Al-Ghafri Hamoud Al-Dhuhli Vaidyanathan Gowri |
| author_facet | Maryam Al-Shukri Wadha Al-Ghafri Hamoud Al-Dhuhli Vaidyanathan Gowri |
| author_sort | Maryam Al-Shukri |
| collection | DOAJ |
| description | Leiomyoma of the uterus, also called fibroids, are common in women. In this case report, we describe the case of a nulliparous woman with a large, prolapsed submucous uterine leiomyoma of 10 × 11 cm was vaginally impacted. The aim is to highlight the challenges in managing such uncommon clinical scenario focusing on the factors predicting the success of vaginal myomectomy including the size of the myoma but also the role of vaginal laxity to allow the steps of devascularization, detachment, and removal of the myoma. We also describe the preoperative and intraoperative methods that can be used to minimize intraoperative blood loss and enhance the safety and feasibility of the surgical procedure. Gonadotropin therapy was not applicable in our patient, and other treatments were also unavailable such as temporary ligation of uterine arteries, while others were unsuccessful like devascularization by hysteroscopy, twisting, and ligation of the pedicle. The final resort used in our case was morcellation of the myoma with intact pedicle, which should be attempted by experienced gynecologic surgeons only. |
| first_indexed | 2024-12-12T16:09:22Z |
| format | Article |
| id | doaj.art-cfbb081bc4564582b6a108f3e1d16538 |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-12-12T16:09:22Z |
| publishDate | 2019-11-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-cfbb081bc4564582b6a108f3e1d165382022-12-22T00:19:14ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042019-11-0134655655910.5001/omj.2019.100Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About SizeMaryam Al-Shukri0Wadha Al-Ghafri1Hamoud Al-Dhuhli2Vaidyanathan Gowri3Department of Obstetrics and Gynecology and Reproductive Science, Sultan Qaboos University Hospital, Muscat, OmanDepartment of Obstetrics and Gynecology and Reproductive Science, Sultan Qaboos University Hospital, Muscat, OmanRadiology Department, Sultan Qaboos University Hospital, Muscat, OmanDepartment of Obstetrics and Gynecology and Reproductive Science, Sultan Qaboos University Hospital, Muscat, OmanLeiomyoma of the uterus, also called fibroids, are common in women. In this case report, we describe the case of a nulliparous woman with a large, prolapsed submucous uterine leiomyoma of 10 × 11 cm was vaginally impacted. The aim is to highlight the challenges in managing such uncommon clinical scenario focusing on the factors predicting the success of vaginal myomectomy including the size of the myoma but also the role of vaginal laxity to allow the steps of devascularization, detachment, and removal of the myoma. We also describe the preoperative and intraoperative methods that can be used to minimize intraoperative blood loss and enhance the safety and feasibility of the surgical procedure. Gonadotropin therapy was not applicable in our patient, and other treatments were also unavailable such as temporary ligation of uterine arteries, while others were unsuccessful like devascularization by hysteroscopy, twisting, and ligation of the pedicle. The final resort used in our case was morcellation of the myoma with intact pedicle, which should be attempted by experienced gynecologic surgeons only.http://omjournal.org/articleDetails.aspx?coType=1&aId=2509prolapseleiomyomauterine artery embolizationvacuum extraction |
| spellingShingle | Maryam Al-Shukri Wadha Al-Ghafri Hamoud Al-Dhuhli Vaidyanathan Gowri Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size Oman Medical Journal prolapse leiomyoma uterine artery embolization vacuum extraction |
| title | Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size |
| title_full | Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size |
| title_fullStr | Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size |
| title_full_unstemmed | Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size |
| title_short | Vaginal Myomectomy for Prolapsed Submucous Fibroid: It is Not Only About Size |
| title_sort | vaginal myomectomy for prolapsed submucous fibroid it is not only about size |
| topic | prolapse leiomyoma uterine artery embolization vacuum extraction |
| url | http://omjournal.org/articleDetails.aspx?coType=1&aId=2509 |
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