This patient is from Coatzacoalcos, we operated on her just yesterday, she is 36 years old but obviously she has not had babies and she gave us a first consultation via Skype because she had three opinions from doctors from there in Veracruz who had told her that she did not have any. probability of preserving the uterus and that the best option was to do a hysterectomy, this patient had fibroids with large elements, 5 in total, but also her main problem was the uterine bleeding or hemorrhages that she had during her menstrual periods that lasted many days but They were also very abundant and therefore with a pathology of moderate anemia, that is, the bleeding caused fatigue, she felt a little tired, and when doing small exercises such as bathing or dressing, she began to have a little sweating and tachycardia.
So we treated him two or three months ago after his first visit with medication to raise hemoglobin and thus be able to schedule the surgery. This surgery is very interesting because although they are well-defined fibroids, the same uterine size and the same sizes of the fibroids It made these fibroids too fibrous and very attached to the muscles, but because of the large blood vessels that were made around them. We are going to see it in the video, they are very thick blood vessels with a lot of blood perfusion and she also had multiple fibroids on all sides of the uterus, it was on the anterior right lateral side, on the left lateral side also anteriorly slightly attached to the great vessels , in the uterine fundus in the musculature and behind intramural but from there another one came out that was pure subserous and so what we did is start first with the right side, then with the left side, then we went to the fundus and finally we We went to the bilobed that was subserous, but it is a surgery that took us about three hours, he did not have to do a blood transfusion, he only bled 500 milliliters, but it is very important to know that when we have multiple fibroids the surgery is going to be more complicated .
I explained to the patient that, yes, many times one of the best options is to remove the uterus, however, in a patient who does not have reproduction or a satisfied reproductive life, the main thing is to preserve the uterus and, after surgery, assess which It is the prognosis of fertility in itself. So the most important thing is for people to know that myomectomy is the first step and should generally be the only or the main step before thinking about removing the uterus.