The Appropriate Criteria in Patients Selection for Myomectomy in the Era  of Minimally Invasive Surgery: A Case Report

Sangam  Jha; Sonia; Hemali  Sinha; Upasna  Sinha

doi:10.18502/jri.v23i4.10818

Sangam Jha Department of Obstetrics and Gynecology, AIIMS Patna, Bihar, India
Sonia Department of Obstetrics and Gynecology, AIIMS Patna, Bihar, India
Hemali Sinha Department of Obstetrics and Gynecology, AIIMS Patna, Bihar, India
Upasna Sinha Department of Radiodiagnosis, AIIMS Patna, Bihar, India

DOI: https://doi.org/10.18502/jri.v23i4.10818

Keywords: Heavy menstrual bleeding, Laparoscopy, Myoma, Uterine myomectomy, Uterine preserving surgery.

Abstract

Background: Myoma is the most common benign monoclonal neoplasm of the uterus with increased frequency during reproductive years of women.

Case Presentation: A twenty two year old female presented with abdomen lump, dysmenorrhoea, and heavy menstrual bleeding. Multiple myomas were diagnosed based on clinical and radiological findings. Abdominal myomectomy was performed and 75 myomas were enucleated followed by reconstruction of uterus. The second case was a 28 year old married woman presented with heavy menstrual bleeding and dysmenorrhoea. Ultrasound reported single posterior wall myoma of 8´6.3´5.8 cm in size. Laparoscopic myomectomy was performed. At follow-up visit, both cases were completely free of any symptoms.

Conclusion: Myomectomy is a feasible and safe option and a uterine preserving surgery even in the presence of multiple myomas. Setting appropriate criteria in selecting patients for abdominal myomectomy rather than MIS is essential to avoid conversion and associated morbidity.