Patient L.T. H. G, 34 years old in Thanh Hoa, was diagnosed with uterine fibroids in 2020. Over time, the tumor continuously developed and by the time of admission, it was about 168 x 119 x 210 mm in size, located deep in the posterior wall of the uterus.
The patient had undergone two cesarean sections, carrying uterine fibroids for many years without fully anticipating the severity. By the time of admission, the tumor had grown to a size equivalent to an 8-month-old fetus, not only causing prolonged pain but also compressing the colon, causing the patient to be frequently constipated, the quality of life clearly declined and facing the risk of having the uterus removed.
Previously, at a front-line medical facility, a treatment plan was proposed to have a hysterectomy to completely eliminate the disease. However, still wanting to have more children, the patient went to the Central Obstetrics and Gynecology Hospital with the hope of preserving the uterus.
According to the assessment of doctors, this is a complex case with many disadvantages: The tumor is very large, located deep behind the uterus, while the patient has a history of two cesarean sections, causing a significant change in anatomical structure. In particular, during surgery, the risk of hysterectomy is always present if complications or severe blood loss occur.
Faced with this situation, doctors conducted a thorough consultation, considering the goal of preserving the uterus and the requirement to ensure maximum safety for the patient. After a comprehensive review, the team decided to choose the option of removing fibroids to retain the uterus, and at the same time prepare fully for any situations that may occur during surgery.
Assoc. Prof. Dr. Nguyen Quoc Tuan - main surgeon - said: With large tumors and such complex locations, we usually choose a vertical surgical line to facilitate exposure and operation. However, in this case, the team decided to approach through a horizontal surgical line along the old scar to ensure aesthetics for the patient.
After more than 2 hours of stressful surgery, doctors successfully completely removed the 2.7kg fibroid tumor. The most important thing is that the patient's uterus was preserved intact.
According to MSc.BS Dam Thi Quynh Lien, Deputy Head of the Department of Gynecology and Surgery, uterine fibroids are benign diseases, quite common in women and many cases only require periodic monitoring. However, when the tumor grows large or causes symptoms, treatment needs to be carefully considered for each patient, especially prioritizing preserving fertility if there are still safe conditions. Even if it is a benign disease, uterine fibroids can still cause menstruation, anemia, prolonged pain, compression of nearby organs and affect fertility.
Doctors recommend that women should have regular gynecological examinations for early detection, close monitoring after tumor removal due to the risk of recurrence, and at the same time be advised on the appropriate time for pregnancy. In cases where there is still an opportunity, doctors always make maximum efforts to preserve the uterus for the patient.
