Vaginal Myomectomy in Pregnancy: A Report of Two Cases

Kilpatrick, Charlie C.; Adler, Michael; Chohan, Lubna

doi:10.1097/smj.0b013e3181efb552

Cited by 23 publications

(25 citation statements)

References 3 publications

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“…[3][4][5]9,10 The procedure is associated with low risk of complications and results in cure of abnormal bleeding and/ or pain in the majority of women. Although blood loss associated with the procedure is usually low, 6.1% of women required perioperative blood transfusion due to anemia.…”

Section: Discussionmentioning

confidence: 99%

Management Considerations for Prolapsed Submucosal Leiomyomata: A Retrospective Cohort Study

Cleveland

ÖzelBegüm

Elizabeth

2015

Journal of Gynecologic Surgery

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Objective: To describe (1) sensitivity/specificity of physical examination to correctly diagnose a prolapsed vaginal mass as benign, (2) success rate for transvaginal myomectomy, (3) risk of associated malignancy. Design: A retrospective cohort study. Materials and Methods: Consecutive patients evaluated at the LAC + USC Medical Center from March 2007 to June 2012 with a diagnosis, including prolapsed leiomyoma, were reviewed. Medical records were reviewed for demographic information, clinical findings, histology reports, and clinical outcomes. Results: Two hundred twenty-six cases were identified. Mean age was 44.2 (-9.1) years and 83.6% of cases were premenopausal. The most common symptom was bleeding (79.2%); 15% of the women were asymptomatic. Most were successfully treated with transvaginal myomectomy, although 14 (6.2%) required urgent hysterectomy. There were no cases of uterine infection before intervention; delay of treatment resulted in acute bleeding in 2 of 18 women. Subsequent hysterectomy was performed in 10.9% of women and was more common in women with additional leiomyomata, compared to those without (24.6% vs. 3.4%, p = 0.004). The positive predictive value of examination to predict malignancy was 21.4%. The sensitivity and specificity of examination to detect malignancy were 42.8% and 95.0%, respectively. Concomitant endometrial hyperplasia or cancer was found in 4.2% of women sampled. Conclusions: The sensitivity of physical examination to exclude malignancy in prolapsing lesions is poor. Delayed management of prolapsed leiomyomata appears safe, but carries some risk of bleeding. The preferred treatment is transvaginal myomectomy, avoiding further surgery in 89.1% of women. Concomitant endometrial sampling should be considered to evaluate for endometrial hyperplasia or malignancy. ( J GYNECOL SURG 31:205)

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Section: Discussionmentioning

confidence: 99%

Management Considerations for Prolapsed Submucosal Leiomyomata: A Retrospective Cohort Study

Cleveland

ÖzelBegüm

Elizabeth

2015

Journal of Gynecologic Surgery

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“…5 Pedinküllü miyomlarda cerrahi müda-halenin daha kolay olduğu düşünülse de erken doğum eylemi, erken membran rüptürü, kanama ve histerektomi gibi istenmeyen sonuçlara yol aça-bileceğinden komplikasyon olmadığı sürece konservatif izlem seçeneğinin daha uygun olduğu düşünülmektedir. 2,5 Miyomların obstrüksiyona yol açmadığı sürece cerrahi müdahale için doğum sonrasına bırakılabileceği belirtilmiştir. 9 Olgumuzda non-pedinküle miyom postpartum ikinci günde prolabe olarak hemorajiye neden olmuş, eksize edilmiş ve komplikasyon gelişmemiştir.…”

Section: Discussionunclassified

“…4 Gebelikte miyomlara vajinal ya da abdominal cerrahi müdahale kontrol edilemeyen kanamaya yol açarak histerektomi gibi dramatik sonuçlara neden olabilirken, enfektif dejenerasyon, dirençli ağrı, masif kanama, üriner retansiyon, distosi gibi komplikasyonlar nadiren müdahale gerektiren durumlar arasındadır. 5,6 Vajinal Doğum Sonrası Servikal Leiomiyom Prolapsusu Ö ÖZ ZE ET T Spontan vajinal doğum sonrası postpartum ikinci günde 5 cm çapındaki servikal miyomun total olarak prolabe olup, hemoraji ile komplike olduğu izlenen olgumuzda miyom eksize edildi ve postoperatif dönemde komplikasyon gelişmedi. Miyom ile komplike olan gebeliklerde komplikasyon olmadığı sürece konservatif yaklaşım seçilmeli, operasyon kaçınılmaz ise preoperatif hazırlık-lar tamamlandıktan sonra operasyon uygulanmalıdır.…”

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Prolapsus of Cervical Leiomyoma After Vaginal Delivery: Case Report

Çöğendez¹,

Anğın²,

Eken³

et al. 2015

Turkiye Klinikleri J Gynecol Obst

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“…6 Prolapsed myoma have also been reported in pregnancy. Two such cases, one cervical and the other submucousal, were recently reported by Kilpatrick CC et al 7 We present here another rare case of a prolapsed submucous myoma with associated uterovaginal prolapse.…”

mentioning

confidence: 81%