Book contents
- Surgical Gynecology
- Surgical Gynecology
- Copyright page
- Contents
- Contributors
- Preface
- Case 1 A 45-Year-Old Woman Undergoing Hysterectomy Requests Oophorectomy
- Case 2 A 40-Year-Old G0 Developmentally Delayed Woman Requires Hysterectomy
- Case 3 A 45-Year-Old Woman with Possible Penicillin Allergy Scheduled for Hysterectomy
- Case 4 A 50-Year-Old Woman with Prior DVT Undergoing Hysterectomy
- Case 5 A 40-Year-Old Woman with Severe Anemia Scheduled for Surgery Refuses Blood Products
- Case 6 A 55-Year-Old Woman Inquires about Your Institution’s Protocols for Enhanced Recovery after Surgery
- Case 7 A 55-Year-Old Female with a 25-Year Smoking History and COPD Is Undergoing a Robotic Hysterectomy
- Case 8 A 48-Year-Old with Adult-Onset Diabetes Is Undergoing a Hysterectomy for Recurrent Simple Hyperplasia
- Case 9 A 10-Year-Old Girl with a Vulvar Hematoma after Playground Injury
- Case 10 A 50-Year-Old Woman with a Discrete Area of Leukoplakia That on In-Office Punch Biopsy Showed VIN 3
- Case 11 A 50-Year-Old Woman with a Recurrent Bartholin’s Gland Cyst
- Case 12 A 21-Year-Old Woman with Labial Pain During Exercise
- Case 13 A 33-Year-Old Woman with Localized Vulvodynia without Vaginismus
- Case 14 A 24-Year-Old Woman with Multiple Large Vulvar Condyloma
- Case 15 A 70-Year-Old with Vulvar Paget’s Disease
- Case 16 A 45-Year-Old Female with Multifocal VIN
- Case 17 A 70-Year-Old Woman with Diabetes, Exquisitely Painful 2 cm Vulvar Ulcerative Lesion, and Subcutaneous Gas on CT Scan
- Case 18 A 14-Year-Old Adolescent with Cyclic Pelvic Pain and Amenorrhea
- Case 19 A 40-Year-Old Woman with a 3 cm Mass Prolapsing through the Cervix
- Case 20 A 35-Year-Old Woman with a Fetal Demise at 20 Weeks’ Gestation
- Case 21 A 25-Year-Old Woman with Intrauterine Embryonic Demise and Temperature of 39.2°C
- Case 22 A 40-Year-Old G0 Woman with Endometrial Intraepithelial Neoplasia Desiring Hysterectomy
- Case 23 A 35-Year-Old G3P3 Woman with a 12-Week Uterus and a Prior Cesarean Section Who Desires Vaginal Hysterectomy
- Case 24 A 42-Year-Old G2P2 Woman Undergoing Vaginal Hysterectomy with Difficulty Entering the Peritoneum
- Case 25 A 28-Year-Old P0 Woman with Adenocarcinoma In Situ Has Intraoperative Bleeding during a Cold-Knife Conization
- Case 26 A 30-Year-Old G1 Woman with Suspected Uterine Perforation during Suction Dilation and Curettage
- Case 27 A 39-Year-Old P4 Woman with Recurrent HSIL after LEEP
- Case 28 A 34-Year-Old G2P1 Woman with Elevated β-hCG (>250 000 mIU/mL) and Concern for Molar Gestation
- Case 29 A 35-Year-Old G3P2 Woman with Persistent Bleeding after Suction D&C
- Case 30 A 70-Year-Old G0 Woman with Postmenopausal Bleeding and Severe Vaginal Atrophy
- Case 31 A 28-Year-Old G3P2 Woman Presents at Eight Weeks with a Cervical Ectopic Pregnancy
- Case 32 A 45-Year-Old Woman with Leg Weakness following a Vaginal Hysterectomy
- Case 33 A 45-Year-Old Woman Undergoes a Transvaginal Midurethral Sling and Is Unable to Void after the Procedure
- Case 34 A 65-Year-Old Woman Presents with a Symptomatic Stage 2 Rectocele
- Case 35 A 55-Year-Old Woman with Stress Urinary Incontinence without Uterine Prolapse
- Case 36 A 45-Year-Old P2 Woman Undergoing Vaginal Hysterectomy Who Desires Opportunistic Salpingectomy
- Case 37 A 32-Year-Old G2P2 with Bleeding from a 5 cm Vaginal Laceration after Sexual Assault
- Case 38 A 50-Year-Old Woman Loses Consciousness during an Office Hysteroscopy
- Case 39 A 44-Year-Old Woman with Intermenstrual Spotting
- Case 40 A 71-Year-Old G2P2 Woman with Postmenopausal Bleeding and Severe Cervical Stenosis
- Case 41 A 34-Year-Old G2P2 Woman with a 4 cm Type 1 Submucosal Myoma Undergoing a Hysteroscopic Myomectomy
- Case 42 A 50-Year-Old Woman with a Retained IUD
- Case 43 A 30-Year-Old Woman Seeking Pregnancy Who Has Intrauterine Synechiae
- Case 44 A 42-Year-Old Woman with Abnormal Uterine Bleeding Who Desires In-Office Ablation
- Case 45 A 55-Year-Old G1P1 Woman with New-Onset Vaginal Bleeding after Prior Endometrial Ablation
- Case 46 A 22-Year-Old G3P0030 Woman with Recurrent Pregnancy Loss and Uterine Septum
- Case 47 A 33-Year-Old G2P2 Woman with Persistent Irregular Vaginal Bleeding after Cesarean Delivery
- Case 48 A 38-Year-Old G3P2 Woman with Pelvic Pain following Endometrial Ablation
- Case 49 A 33-Year-Old Woman with Acute Hypoxia during Hysteroscopic Myomectomy
- Case 50 A 40-Year-Old Woman Desires Endometrial Ablation for Heavy Menstrual Bleeding
- Case 51 A 24-Year-Old G0 Woman with Suspected Endometriosis Who Has Failed Medical Management
- Case 52 A 35-Year-Old G0 Woman with Chronic Pain and Multiple Prior Surgeries Undergoing Diagnostic Laparoscopy
- Case 53 A 25-Year-Old Woman with Sudden Cardiovascular Collapse after Creation of Pneumoperitoneum
- Case 54 A 30-Year-Old G0 Woman with 6 cm Complex Ovarian Cyst Suspicious for Borderline Ovarian Tumor
- Case 55 A 32-Year-Old G4P4 Woman with Through-and-Through Small Bowel Penetration on Placement of Umbilical Port
- Case 56 A 43-Year-Old G3P3 BRCA1 Carrier Desiring Risk-Reducing Salpingo-oophorectomy
- Case 57 A 34-Year-Old G3P3 Is Undergoing an Interval Bilateral Salpingectomy. During Initial Trocar Insertion, Bright Red Blood Is Noted to Be Filling the Pelvis
- Case 58 A 28-Year-Old G0 Woman with Stage IV Endometriosis and an Obliterated Posterior Cul-de-sac
- Case 59 A 40-Year-Old G3P3 Woman with 20 cm Unilateral Simple Cyst
- Case 60 A 16-Year-Old Female G0 Adolescent with Acute Pelvic Pain
- Case 61 A 29-Year-Old G2P0 Woman with Symptomatic Ectopic Pregnancy and History of Prior Salpingectomy
- Case 62 A 35-Year-Old P2 Woman with Preperitoneal Insufflation at Time of Laparoscopy
- Case 63 A 38-Year-Old Woman Who Desires Device Removal after Hysteroscopic Sterilization
- Case 64 A 28-Year-Old Woman with a 6 cm Complex Mass Adherent to the Pelvic Sidewall
- Case 65 A 21-Year-Old Woman with an 8 cm Adnexal Mass Presumed to Be a Dermoid Tumor
- Case 66 A 24-Year-Old G2P1 Woman with an Eight-Week Interstitial Ectopic Pregnancy
- Case 67 A 16-Year-Old G0 Adolescent with Acute Psychosis and 3 cm Ovarian Dermoid Cyst
- Case 68 A 23-Year-Old Woman with Cyclic Pelvic Pain and Suspected Obstructed Rudimentary Uterine Horn
- Case 69 A 31-Year-Old Woman with Cesarean Scar Pregnancy
- Case 70 A 35-Year-Old Woman with Bleeding from a Right Lower Abdominal Trocar Site
- Case 71 A 21-Year-Old Woman with an Intra-abdominal IUD
- Case 72 A 32-Year-Old G2P1 Woman with Ovarian Pregnancy Noted at Time of Surgery for Presumed Tubal Ectopic
- Case 73 A 32-Year-Old P0 Woman with Persistent Pain after LAVH/BSO for Endometriosis
- Case 74 A 50-Year-Old Woman with Bleeding with Intercourse Four Weeks after Robotic Hysterectomy
- Case 75 A 42-Year-Old Woman Who Desires Minimally Invasive Surgery for a 20-Week-Sized Uterus
- Case 76 A 40-Year-Old Woman with No Spill from Her Left Ureter on Postoperative Cystoscopy after Total Laparoscopic Hysterectomy with Bilateral Salpingectomy
- Case 77 A 40-Year-Old G1P1 Woman with Endometriosis Desiring Definitive Management
- Case 78 A 40-Year-Old G4P4 Woman with 16-Week-Size Fibroid Uterus and Abnormal Uterine Bleeding Desiring Hysterectomy
- Case 79 A 45-Year-Old Woman with Vaginal Bleeding and Fever to 38.3°C after Hysterectomy
- Case 80 A 45-Year-Old Woman with Decreased Urine Output on POD#1 after Robotic-Assisted Total Laparoscopic Hysterectomy
- Case 81 A 38-Year-Old G0 Woman with a 4 Cm Umbilical Mass
- Case 82 A 26-Year-Old G0 Woman with Large Multifibroid Uterus Desiring Myomectomy
- Case 83 A 45-Year-Old Woman with a Foul-Smelling Pfannenstiel Incision on POD 7
- Case 84 A 45-Year-Old Woman with Watery Vaginal Discharge Six Weeks after Hysterectomy
- Case 85 A 34-Year-Old G0 Jehovah’s Witness Undergoing Myomectomy
- Case 86 A 50-Year-Old G0 Woman with Class III Obesity Undergoing Abdominal Hysterectomy
- Case 87 A 60-Year-Old G2P2 Woman with Nausea and Abdominal Distension Following Abdominal Hysterectomy and Lysis of Bowel Adhesions
- Case 88 A 15-Year-Old Adolescent with Severe Abdominal Pain and Hemoperitoneum
- Case 89 A 24-Year-Old Woman Presents with Evidence of a Ruptured Ectopic Pregnancy and Is Reporting Concomitant Fever, Chills, and a Productive Cough
- Case 90 A 26-Year-Old Female Presents for Nexplanon Removal with a Non-palpable Device
- Index
- References
Case 86 - A 50-Year-Old G0 Woman with Class III Obesity Undergoing Abdominal Hysterectomy
Published online by Cambridge University Press: 19 November 2021
Book contents
- Surgical Gynecology
- Surgical Gynecology
- Copyright page
- Contents
- Contributors
- Preface
- Case 1 A 45-Year-Old Woman Undergoing Hysterectomy Requests Oophorectomy
- Case 2 A 40-Year-Old G0 Developmentally Delayed Woman Requires Hysterectomy
- Case 3 A 45-Year-Old Woman with Possible Penicillin Allergy Scheduled for Hysterectomy
- Case 4 A 50-Year-Old Woman with Prior DVT Undergoing Hysterectomy
- Case 5 A 40-Year-Old Woman with Severe Anemia Scheduled for Surgery Refuses Blood Products
- Case 6 A 55-Year-Old Woman Inquires about Your Institution’s Protocols for Enhanced Recovery after Surgery
- Case 7 A 55-Year-Old Female with a 25-Year Smoking History and COPD Is Undergoing a Robotic Hysterectomy
- Case 8 A 48-Year-Old with Adult-Onset Diabetes Is Undergoing a Hysterectomy for Recurrent Simple Hyperplasia
- Case 9 A 10-Year-Old Girl with a Vulvar Hematoma after Playground Injury
- Case 10 A 50-Year-Old Woman with a Discrete Area of Leukoplakia That on In-Office Punch Biopsy Showed VIN 3
- Case 11 A 50-Year-Old Woman with a Recurrent Bartholin’s Gland Cyst
- Case 12 A 21-Year-Old Woman with Labial Pain During Exercise
- Case 13 A 33-Year-Old Woman with Localized Vulvodynia without Vaginismus
- Case 14 A 24-Year-Old Woman with Multiple Large Vulvar Condyloma
- Case 15 A 70-Year-Old with Vulvar Paget’s Disease
- Case 16 A 45-Year-Old Female with Multifocal VIN
- Case 17 A 70-Year-Old Woman with Diabetes, Exquisitely Painful 2 cm Vulvar Ulcerative Lesion, and Subcutaneous Gas on CT Scan
- Case 18 A 14-Year-Old Adolescent with Cyclic Pelvic Pain and Amenorrhea
- Case 19 A 40-Year-Old Woman with a 3 cm Mass Prolapsing through the Cervix
- Case 20 A 35-Year-Old Woman with a Fetal Demise at 20 Weeks’ Gestation
- Case 21 A 25-Year-Old Woman with Intrauterine Embryonic Demise and Temperature of 39.2°C
- Case 22 A 40-Year-Old G0 Woman with Endometrial Intraepithelial Neoplasia Desiring Hysterectomy
- Case 23 A 35-Year-Old G3P3 Woman with a 12-Week Uterus and a Prior Cesarean Section Who Desires Vaginal Hysterectomy
- Case 24 A 42-Year-Old G2P2 Woman Undergoing Vaginal Hysterectomy with Difficulty Entering the Peritoneum
- Case 25 A 28-Year-Old P0 Woman with Adenocarcinoma In Situ Has Intraoperative Bleeding during a Cold-Knife Conization
- Case 26 A 30-Year-Old G1 Woman with Suspected Uterine Perforation during Suction Dilation and Curettage
- Case 27 A 39-Year-Old P4 Woman with Recurrent HSIL after LEEP
- Case 28 A 34-Year-Old G2P1 Woman with Elevated β-hCG (>250 000 mIU/mL) and Concern for Molar Gestation
- Case 29 A 35-Year-Old G3P2 Woman with Persistent Bleeding after Suction D&C
- Case 30 A 70-Year-Old G0 Woman with Postmenopausal Bleeding and Severe Vaginal Atrophy
- Case 31 A 28-Year-Old G3P2 Woman Presents at Eight Weeks with a Cervical Ectopic Pregnancy
- Case 32 A 45-Year-Old Woman with Leg Weakness following a Vaginal Hysterectomy
- Case 33 A 45-Year-Old Woman Undergoes a Transvaginal Midurethral Sling and Is Unable to Void after the Procedure
- Case 34 A 65-Year-Old Woman Presents with a Symptomatic Stage 2 Rectocele
- Case 35 A 55-Year-Old Woman with Stress Urinary Incontinence without Uterine Prolapse
- Case 36 A 45-Year-Old P2 Woman Undergoing Vaginal Hysterectomy Who Desires Opportunistic Salpingectomy
- Case 37 A 32-Year-Old G2P2 with Bleeding from a 5 cm Vaginal Laceration after Sexual Assault
- Case 38 A 50-Year-Old Woman Loses Consciousness during an Office Hysteroscopy
- Case 39 A 44-Year-Old Woman with Intermenstrual Spotting
- Case 40 A 71-Year-Old G2P2 Woman with Postmenopausal Bleeding and Severe Cervical Stenosis
- Case 41 A 34-Year-Old G2P2 Woman with a 4 cm Type 1 Submucosal Myoma Undergoing a Hysteroscopic Myomectomy
- Case 42 A 50-Year-Old Woman with a Retained IUD
- Case 43 A 30-Year-Old Woman Seeking Pregnancy Who Has Intrauterine Synechiae
- Case 44 A 42-Year-Old Woman with Abnormal Uterine Bleeding Who Desires In-Office Ablation
- Case 45 A 55-Year-Old G1P1 Woman with New-Onset Vaginal Bleeding after Prior Endometrial Ablation
- Case 46 A 22-Year-Old G3P0030 Woman with Recurrent Pregnancy Loss and Uterine Septum
- Case 47 A 33-Year-Old G2P2 Woman with Persistent Irregular Vaginal Bleeding after Cesarean Delivery
- Case 48 A 38-Year-Old G3P2 Woman with Pelvic Pain following Endometrial Ablation
- Case 49 A 33-Year-Old Woman with Acute Hypoxia during Hysteroscopic Myomectomy
- Case 50 A 40-Year-Old Woman Desires Endometrial Ablation for Heavy Menstrual Bleeding
- Case 51 A 24-Year-Old G0 Woman with Suspected Endometriosis Who Has Failed Medical Management
- Case 52 A 35-Year-Old G0 Woman with Chronic Pain and Multiple Prior Surgeries Undergoing Diagnostic Laparoscopy
- Case 53 A 25-Year-Old Woman with Sudden Cardiovascular Collapse after Creation of Pneumoperitoneum
- Case 54 A 30-Year-Old G0 Woman with 6 cm Complex Ovarian Cyst Suspicious for Borderline Ovarian Tumor
- Case 55 A 32-Year-Old G4P4 Woman with Through-and-Through Small Bowel Penetration on Placement of Umbilical Port
- Case 56 A 43-Year-Old G3P3 BRCA1 Carrier Desiring Risk-Reducing Salpingo-oophorectomy
- Case 57 A 34-Year-Old G3P3 Is Undergoing an Interval Bilateral Salpingectomy. During Initial Trocar Insertion, Bright Red Blood Is Noted to Be Filling the Pelvis
- Case 58 A 28-Year-Old G0 Woman with Stage IV Endometriosis and an Obliterated Posterior Cul-de-sac
- Case 59 A 40-Year-Old G3P3 Woman with 20 cm Unilateral Simple Cyst
- Case 60 A 16-Year-Old Female G0 Adolescent with Acute Pelvic Pain
- Case 61 A 29-Year-Old G2P0 Woman with Symptomatic Ectopic Pregnancy and History of Prior Salpingectomy
- Case 62 A 35-Year-Old P2 Woman with Preperitoneal Insufflation at Time of Laparoscopy
- Case 63 A 38-Year-Old Woman Who Desires Device Removal after Hysteroscopic Sterilization
- Case 64 A 28-Year-Old Woman with a 6 cm Complex Mass Adherent to the Pelvic Sidewall
- Case 65 A 21-Year-Old Woman with an 8 cm Adnexal Mass Presumed to Be a Dermoid Tumor
- Case 66 A 24-Year-Old G2P1 Woman with an Eight-Week Interstitial Ectopic Pregnancy
- Case 67 A 16-Year-Old G0 Adolescent with Acute Psychosis and 3 cm Ovarian Dermoid Cyst
- Case 68 A 23-Year-Old Woman with Cyclic Pelvic Pain and Suspected Obstructed Rudimentary Uterine Horn
- Case 69 A 31-Year-Old Woman with Cesarean Scar Pregnancy
- Case 70 A 35-Year-Old Woman with Bleeding from a Right Lower Abdominal Trocar Site
- Case 71 A 21-Year-Old Woman with an Intra-abdominal IUD
- Case 72 A 32-Year-Old G2P1 Woman with Ovarian Pregnancy Noted at Time of Surgery for Presumed Tubal Ectopic
- Case 73 A 32-Year-Old P0 Woman with Persistent Pain after LAVH/BSO for Endometriosis
- Case 74 A 50-Year-Old Woman with Bleeding with Intercourse Four Weeks after Robotic Hysterectomy
- Case 75 A 42-Year-Old Woman Who Desires Minimally Invasive Surgery for a 20-Week-Sized Uterus
- Case 76 A 40-Year-Old Woman with No Spill from Her Left Ureter on Postoperative Cystoscopy after Total Laparoscopic Hysterectomy with Bilateral Salpingectomy
- Case 77 A 40-Year-Old G1P1 Woman with Endometriosis Desiring Definitive Management
- Case 78 A 40-Year-Old G4P4 Woman with 16-Week-Size Fibroid Uterus and Abnormal Uterine Bleeding Desiring Hysterectomy
- Case 79 A 45-Year-Old Woman with Vaginal Bleeding and Fever to 38.3°C after Hysterectomy
- Case 80 A 45-Year-Old Woman with Decreased Urine Output on POD#1 after Robotic-Assisted Total Laparoscopic Hysterectomy
- Case 81 A 38-Year-Old G0 Woman with a 4 Cm Umbilical Mass
- Case 82 A 26-Year-Old G0 Woman with Large Multifibroid Uterus Desiring Myomectomy
- Case 83 A 45-Year-Old Woman with a Foul-Smelling Pfannenstiel Incision on POD 7
- Case 84 A 45-Year-Old Woman with Watery Vaginal Discharge Six Weeks after Hysterectomy
- Case 85 A 34-Year-Old G0 Jehovah’s Witness Undergoing Myomectomy
- Case 86 A 50-Year-Old G0 Woman with Class III Obesity Undergoing Abdominal Hysterectomy
- Case 87 A 60-Year-Old G2P2 Woman with Nausea and Abdominal Distension Following Abdominal Hysterectomy and Lysis of Bowel Adhesions
- Case 88 A 15-Year-Old Adolescent with Severe Abdominal Pain and Hemoperitoneum
- Case 89 A 24-Year-Old Woman Presents with Evidence of a Ruptured Ectopic Pregnancy and Is Reporting Concomitant Fever, Chills, and a Productive Cough
- Case 90 A 26-Year-Old Female Presents for Nexplanon Removal with a Non-palpable Device
- Index
- References
Summary
A 50-year-old female, gravida 0, presents to discuss hysterectomy for definitive treatment of heavy menses. She has had heavy menstrual bleeding for many years despite trials of a levonorgestrel intrauterine device and depot medroxyprogesterone. She has required blood transfusions for anemia related to the heavy bleeding. She has a medical history significant for class III obesity, diabetes, and hypertension. She had three prior cesarean deliveries and a tubal ligation. She has no significant social or family history. She takes metformin, lisinopril, and hydrochlorothiazide.
- Type
- Chapter
- Information
- Surgical GynecologyA Case-Based Approach, pp. 263 - 265Publisher: Cambridge University PressPrint publication year: 2021
References
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