MR imaging and clinical features associated with intraoperative hemorrhage during laparoscopic myomectomy
This study included 126 patients clinically and pathologically diagnosed as uterine leiomyoma between 2010 and 2015. These findings were statistically compared between significant intraoperative hemorrhage group (greater than 300 ml) and nonsignificant intraoperative hemorrhage group (less than 300 ml). Correlation between the maximum diameter of resected leiomyomas and the maximum diameter leiomyomas on MR imaging were also evaluated. Significant hemorrhage group showed larger maximum diameter of resected leiomyoma (p = 0.01), larger maximum diameter of leiomyoma on MR imaging (p = 0.01) and have cellular leiomyomas on MR imaging more frequently (p = 0.03) than nonsignificant intraoperative hemorrhage group. The maximum diameter of resected leiomyomas significantly correlated with that of leiomyomas on MR imaging (Spearman’s rho = 0.797, p < 0.001). The cutoff value of maximum diameter of uterine leiomyoma on MR imaging between both groups was 7.27 cm. The MR imaging findings of a large uterine leiomyoma (more than about 7.3 cm) may predict significant intraoperative blood loss during laparoscopic myomectomy.
ConclusionUse of cellulose absorbable barrier at the time of laparoscopic myomectomy reduces the risk of postoperative adhesions.
Rationale: Uterine leiomyoma, which is very common gynecological tumor in the reproductive years, is extremely rare in adolescence. We herein report a case of a uterine leiomyoma treated with laparoscopic surgery in an adolescent. Patient concerns: A 13-year-old girl with no gravida and her first menses at 11 years of age reported feeling bloated. She had a regular menstrual cycle but felt increased abdominal distension. Diagnosis: Transabdominal ultrasound and magnetic resonance imaging revealed uterine leiomyoma with a diameter of 10 cm. Intervention: Laparoscopic myomectomy was performed. Outcomes: The t...
Authors: Vilos GA, Vilos AG, Abu-Rafea B, Leyland N, Allaire C, Laberge PY, Murji A, Singh SS, Thiel J Abstract Uterine leiomyomas (myomas, fibroids) are very common in premenopausal women and frequently are associated with abnormal uterine bleeding, bulk effects, and reproductive issues. In women who wish to retain their uterus and/or to enhance or retain fertility, interventional therapies have been introduced, including radiofrequency, laser (chromo), cryotherapy, and magnetic resonance (MR)-guided high-intensity focused ultrasound (MRgHIFU) myolysis. In formulating this commentary, all modalities of myolysis fr...
45-year-old Female presented to outpatient clinic in Alzahra university hospital, Al-Azhar University, Egypt by abdominal mass. The patient had a history of primary amenorrhea, primary dyspareunia and primary infertility. Past history of diagnostic laparoscopy 22 years ago which reported the presence of ovaries while the uterus and fallopian tubes were absent. The family history was irrelevant regarding this anomaly and other genetic ones. General examination showed a good general health of the patient and the secondary sexual characters were well developed.
Conclusions: The surgeons performing LM in women pre-treated with UPA should be aware of the abnormal texture of enucleated myomas. Nevertheless, this does not negatively affect the other surgical and clinical outcomes of these patients. PMID: 31617772 [PubMed - as supplied by publisher]
Publication date: Available online 15 October 2019Source: Case Reports in Women's HealthAuthor(s): Hiroshi Sato, Yukako Mizuno, Sunao Matsuzaka, Tatsuro Horiuchi, Shota Kanbayashi, Miho Masuda, Ayaka Nakashima, Makiko Ikeda, Miki Yasuda, Hajime Morishita, Yukiko Ando, Kenji Oida, Nao Taguchi, Masaya HiroseAbstractAbdominal pregnancy is a rare form of ectopic pregnancy. Various sites of implantation in abdominal pregnancy have been reported. Uterine serosa is an extremely rare implantation site, with only a few cases reported to date. No case of abdominal pregnancy implanted on the surface of a subserosal uterine leiomyoma ...
ConclusionRA-LESS myomectomy is a safe and feasible surgery with excellent cosmetic and postoperative outcomes in selected patients. Further investigation is needed to define the patient groups that will most benefit from it.
To present a case of primary solitary large anterior abdominal wall leiomyoma
Subendothelial (intracavitary) leiomyomas are rare and can be challenging to manage. They commonly recur and can present with significant abnormal uterine bleeding or infertility. Our objective is to discuss the clinical presentation, diagnosis and management of this rare condition. The patients in these series presented with either heavy menstrual bleeding or infertility. Preoperative imaging studies showed multiple small fibroids, however the diagnosis was not confirmed until the uterus was surgically evaluated.
We describe a case report of a postmenopausal patient who presented with incidental adnexal masses, underwent a diagnostic laparoscopy and was ultimately diagnosed with parasitic leiomyoma. We discuss the differential diagnosis, symptomatology, origin and epidemiology of this rare diagnosis.