Prophylactic Ureteral Stenting in the Excision of Large Broad Ligament Fibroid

Abstract

Leiomyomas in uterine broad ligaments are usually asymptomatic but may grow to a very large size and alter the pelvic anatomy. This may result in difficulties during surgical excision with attendant complications, the most serious one being ureteral injury. A 45 year old lady presented with pain and distension of abdomen. On evaluation, a pelvic mass of 28 weeks size of varying consistency was observed. Ultra sonogram and Magnetic Resonance Imaging confirmed the diagnosis of right sided broad ligament fibroid. Anticipating possible ureteral injury owing to its size, preoperative stenting of the ureters was performed. Laparotomy was performed with the excision of tumour in toto, followed by total abdominal hysterectomy and bilateral salpingo-oopherectomy. With the postoperative period being uneventful, ureteral stent was removed.