We are going to talk about a subject that we have already touched on previously, which is uterine fibroids in reproductive age. In this particular case, the patient had 5 fibroids, of which the 5 were completely subserous, that is, they were on the outside as if they were small uterus outside the uterus. but they were of very large dimensions to such an extent that they reached up to the umbilical scar.

FIBROID SURGERY

This patient that we are showing in the video right now is 36 years old, but she has previously seen two doctors and the first one told her that she had a hernia and then she did not feel very sure because she felt something at the level of the umbilical scar that It did not seem normal to him, so the importance of seeing the location of the fibroids is to also know the approach.

The fibroid that is inside the cavity called submucous generally we introduce a tube vaginally. We enter through the cervical canal and access through a route called hysteroscopy. Fibroids with large elements that are above the cavity and the uterus are through the abdomen and are generally open. The laparoscopic approach is very good, however, for large tumors, it can sometimes be a surgery with a long evolution in surgical time, so doing a small open surgery, which is called a mini laparotomy, is better accessible, we have better maneuverability, we can remove tumors of large dimensions without such a large incision but also the surgical period is very short. Now we have finished the surgery, it was two hours of surgery, a little complicated due to the size of the fibroids.

The largest that measures more or less 10 centimeters. The 2 pedicles that were bilobed This bilobed one was also… multilobed and pedunculated, very vascularized and a 5th here that was completely subserous but the surgery was over in two hours and he bled more or less 300 ml.

This little patient, fortunately as she did not attack or cover so much uterine muscle tissue, surely in three or four months she could seek pregnancy.

How do I know if I have myomatosis?

Many patients ask us, well, how do I know if I have fibroids or not? It is important to know that one in three women may have uterine fibroids and not necessarily have any symptoms or signs or data for her to diagnose fibroids, but we are going to break down some signs or symptoms that the patient may have. What is a very important sign? ? The patient feels that her abdominal volume has grown or has increased in the last six months or a year, that she previously did not have that tumor or that feeling of abdominal distension. What is a symptom? The symptoms are:

1. The patient may have constipation and say that before she did not have constipation and now I have great difficulty in evacuating.
2. She may have heavier bleeding. This patient can normally regulate well and from a year on say “It’s just that now my bleeding lasts longer or my bleeding is more abundant.”
3. Many patients who have profuse bleeding and therefore will have symptoms of fatigue are patients who say “hey, now I get very tired, or I can go to a shopping center for a walk and I feel exhausted, so I have to stop to rest” This is because the patient could have anemia and then when being able to do exercises or physical activities, there begins to be a feeling of lack of air because we have low hemoglobin.
4. Pain during sexual intercourse, patients say “hey, now it bothers me when I have sexual life and I feel like something is hitting me inside”.
5. They themselves may feel that they have a growth that feels stiff or hard that they did not have before.

Conclusions

But the most important thing is that every woman of reproductive age, that this goes from the time we begin to have a sexual life until the age of 45 or 50, the ideal is to have a minimum annual gynecological check-up. What does this mean? Go to a gynecologist to do our study, pap smear, breast review, but the most important thing I tell patients is an ultrasound and preferably vaginally. Why vaginally? Because vaginal access will allow us to have better visualization and obviously a diagnosis that is almost 100% accurate as to whether we have a fibroid tumor. But the most important thing the patient wants to know is that in reproductive life languages are very frequent, they are benign and not all are surgical.

I want to invite you to come with us, to call and if it is a myomatosis and it is surgical, go to the specialist. Why? Because we are going to try to preserve the uterus, which is the most important thing so that later we can have a normal life and a fertile life, and obviously going to a specialist deserves less wasted time, fewer surgical risks and better preservation of the uterus and ovaries. and obviously later visualize when we can get pregnant

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