Vaginal myomectomy of a prolapsed gangrenous cervical leiomyoma

Ikechebelu, JI; Eleje, George Uchenna; Okpala, Boniface Chukwuneme; Onyiaorah, IV; Umeobika, JC; Onyegbule, OA; Ejikeme, BT

doi:10.4103/1119-3077.100648

Cited by 20 publications

(25 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the MRI pelvis helped in confirming the diagnosis of prolapsed cervical fibroid polyp without any pelvic organ prolapse. Similar cases of huge prolapsed necrotic cervical fibroid polyp have been reported by Khan et al in 2011 [ 6 ] and Ikechebelu et al in 2012 [ 7 ]. However, in both these cases, MR imaging was not done.…”

Section: Discussionsupporting

confidence: 83%

“…Cervical fibroid may lead to urinary retention, frequency of micturition, constipation, menstrual abnormalities, dyspareunia or postcoital bleeding [ 2 - 3 ]. Huge cervical fibroid can rarely present as a polypoidal vaginal mass [ 4 - 5 ], can even mimic incarcerated procidentia [ 6 - 7 ] or can masquerade as chronic uterine inversion [ 8 ]. It can also cause uterocervical descent as a result of traction [ 9 - 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Gupta¹,

Gupta²,

Manaktala³

2018

Cureus

View full text Add to dashboard Cite

Cervical leiomyomas or fibroids constitute a rare variety of benign pelvic tumors. The symptoms may vary from urinary retention, frequency, dyspareunia to rare clinical presentations such as prolapsed cervical fibroid polyp which may mimic procidentia or even uterine inversion. Preoperative clinical evaluation, radiological imaging, and proper intra-operative delineation of pelvic anatomy can help in their successful management. We are presenting a series of three cases of cervical leiomyomas which presented as a diagnostic challenge but their proper evaluation ultimately led us to manage these cases judiciously. The first case of cervical fibroid polyp mimicked incarcerated procidentia, the second case mimicked pelvic organ prolapse while the third case presented with acute urinary retention. All these cases were evaluated by ultrasound as well as magnetic resonance imaging (MRI) and were managed surgically without any complications. The MRI features of all the cases have been described. One should be aware of the uncommon presentations of cervical fibroid and should consider it in the differential diagnosis of any pelvic mass.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Gupta¹,

Gupta²,

Manaktala³

2018

Cureus

View full text Add to dashboard Cite

show abstract

“…[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

View full text Add to dashboard Cite

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)

show abstract

“…3 There are 4 more similar reports of uterine prolapse due to cervical fibroids in English medical literature. [4][5][6][7] One of these cases was similarly managed by vaginal myomectomy due to comorbidity. 4 It is the only reported case of prolapse of such a huge myxoid leiomyoma .…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] One of these cases was similarly managed by vaginal myomectomy due to comorbidity. 4 It is the only reported case of prolapse of such a huge myxoid leiomyoma . Management of this case was challenging as the patient was not fit for anaesthesia and major surgery.…”

Section: Discussionmentioning

confidence: 99%

Huge myxoid leiomyoma of cervix presenting as irreducible prolapse-management by vaginal myomectomy

Mishra

Malik

Agarwal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Vaginal myomectomy of a prolapsed gangrenous cervical leiomyoma

Cited by 20 publications

References 4 publications

Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Management Considerations for Prolapsed Submucosal Leiomyomata: A Retrospective Cohort Study

Huge myxoid leiomyoma of cervix presenting as irreducible prolapse-management by vaginal myomectomy

Contact Info

Product

Resources

About