Laparoscopic Myomectomy for Huge Uterine Fibroid in Sub-Saharan Africa: A Case Report

Abstract

Abstract The prevalence of extensive and multiple uterine fibroids among the Black African population is a significant concern, as it limits the available management options. The focus on girl child education and improvement in women empowerment have contributed to an increased demand for less invasive options in the management of uterine fibroids. This trend aims to improve cosmesis and, more importantly, facilitate an early return to work and normal activity. In sub-Saharan Africa, the available management options for uterine fibroids have primarily been limited to abdominal myomectomy and hysterectomy. However, anecdotal reports indicate the use of less invasive management options such as uterine artery embolization, laparoscopic radiofrequency ablation, and laparoscopic myomectomy. These interventions are reserved for small- and medium-sized fibroids, with the largest being <15 cm and usually not more than five myoma nodules. We present a case report of laparoscopic myomectomy for a huge uterine fibroid weighing 2.4 kg in a nulliparous patient. In well-selected, properly evaluated patients with large subserous uterine fibroids, laparoscopic myomectomy emerges as a viable option that could be offered as an armamentarium in the management of huge fibroids, particularly in sub-Saharan Africa.