Abstract
Background: Uterine fibroids (leiomyomas) are benign smooth muscle tumours of the uterus. They are the commonest benign pelvic tumour in females. They occur in nearly 50% of women over 35 years of age, with an increased prevalence during the reproductive phase due to hormone-stimulated growth. 80% of African and approximately 70% of Caucasian women will have fibroids by the age of 50. There are both medical and surgical options for the management of uterine fibroids. We report a case of a 49-year-old Caucasian female, parity zero (P0), with a multiple fibroid uterus, the largest fibroid measuring 11 cm. She had opted against medical management (including GnRH analogues) and due to her medical history, she was unable to have uterine artery embolisation. She was admitted for elective total abdominal hysterectomy and bilateral salpingo-oophorectomy. This procedure proved to be difficult and complex due to the multiple large fibroids. Multiple fibroid enucleations were performed to gain access to the uterus, vagina, and cervix. We discuss the complexity and uniqueness of this surgical case and the current management options for uterine fibroids.
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