FERTILITY PRESERVATION AND EARLY POSTOPERATIVE CHALLENGESIN MYOMECTOMY- CASE REPORT AND REVIEW OF THE LITERATURE

Abstract

Myomas or fibroids represent the most frequent type of genital benign tumor in women. Abdominalmyomectomy was developed in the early 1900s as a conservative treatment for women with uterinemyomas. A 29-year-old woman was admitted in our clinic for menomethrorragia and lowerabdominal pain. She had no obstetrical past regarding abortions or deliveries but she desired toobtain a pregnancy in the future. The clinical and ultrasound examination revealed an enlargeduterus of about 10/9 cm with a 8/7 cm fibroid involving the entire anterior wall. We decided toperform myomectomy. Laparotomy was the choice instead of laparoscopy, considering the size andlocalization of the myoma. We succeeded to remove the fibroid, control the bleeding and let theuterus in place. Postoperative the patient presented anemia with hemoglobin levels between 6-8g/dl due to heavy intraoperative blood loss. She received blood products to correct the anemia. Shewas discharged 5 days after the surgery and made a check visit one month later. She had nocomplaints and there was no pathology according to her physical examination. We report the caseof a young woman with uterine large intramyometrial fibroid. The challenge of this case was topreserve uterus and fertility after myomectomy in consideration of the heavy operative hemorrhage.