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laparoscopic vs vaginal hysterectomy

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Case 78 - A 40-Year-Old G4P4 Woman with 16-Week-Size Fibroid Uterus and Abnormal Uterine Bleeding Desiring Hysterectomy
- By C. Nathan Webb
Edited by Todd R. Jenkins, University of Alabama, Birmingham, Lisa Keder, Abimola Famuyide, Kimberly S. Gecsi, David Chelmow
Book:

Surgical Gynecology

Published online:

19 November 2021

Print publication:

02 December 2021, pp 238-240
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Summary

A 40-year-old gravida 4, para 4 woman presents to the office for heavy menstrual bleeding and bulk symptoms secondary to uterine leiomyoma. She reports regular menses with heavier bleeding over the past year and more recently has developed episodic intermenstrual bleeding. She notes bulk symptoms of dull pelvic pain, urinary frequency, occasional constipation, and dyspareunia. Attempts have been made to manage her symptoms with combined oral contraceptive tablets and non-steroidal anti-inflammatory drugs for several months; however, neither provided significant relief. During this visit she requests hysterectomy. Her past obstetrical history is significant for two term vaginal deliveries, the largest fetus weighing 3700 g at birth, and two cesarean deliveries at term, the latter with concomitant bilateral tubal ligation. She has no past medical or surgical history.