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Abstract: A 50-year-old female patient who had previously visited a clinic for examination and diagnosis of uterine fibroids (exact size unknown), but had no discomfort symptoms such as abdominal pain or menstrual abnormalities, and no significant increase in size was seen on regular examination, so she was not treated. However, 1+ years of irregular menstruation, prolonged menstruation, increased menstrual flow, and symptoms of spotting bleeding appeared about 5 days ago and continued unabated and she sought medical attention. After examination, she was diagnosed with uterine fibroids and was discharged after surgery.
Basic information】Female, 50 years old
Type of disease】Abnormal uterine bleeding
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】May 2022
Treatment plan】Surgical treatment (total laparoscopic hysterectomy + double tubectomy)
Treatment period】7 days in hospital, review after 1 month
Results】Smooth surgery, good recovery after surgery
I. Initial consultation
The patient reported that she had visited a gynecological examination in the past and was diagnosed with uterine fibroids (the exact size is not known), but she did not have any abdominal pain, abdominal distension or other uncomfortable symptoms, and the fibroids showed growth during the examination, but did not increase significantly, so she did not pay attention to them. In the past 1+ years, she had symptoms such as increased menstrual flow and prolonged menstruation, and 5 days ago, she had symptoms of non-menstrual spotting bleeding that lasted for a long time. The gynecological ultrasound examination showed that the endometrial echogenicity was unevenly thickened, and endometrial lesions were not excluded; the uterus was unevenly enlarged (about 7.1×5.6×6.7 cm), and fibroids and adenomyosis were suspected.
II. Treatment history
The patient had abnormal uterine bleeding and was firstly treated with hysteroscopy + segmental scraping, and the pathological findings suggested no malignant lesions. The patient’s age and condition were taken into consideration, and the patient and her family signed a consent form for surgery after talking with her. After that, laparoscopic total hysterectomy + double salpingo-oophorectomy was performed under general anesthesia, and the operation went smoothly.
III. Treatment results
The patient reported no abdominal pain, normal bowel movements, no fever and other uncomfortable symptoms 3 days after the operation, suggesting no postoperative infection, and was discharged from the hospital 4 days after the operation. The patient was discharged 4 days after the operation. He was rechecked in the outpatient clinic one month later, and the wound healed well.
IV. Precautions
The patient recovered quickly with active cooperation in treatment, and I was happy for her from the bottom of my heart.
1. Pay attention to rest, forbid bathing for one month, forbid sexual intercourse for three months, refrain from heavy physical labor for six months, and exercise the pelvic floor muscles appropriately.
2, usually keep the vulva clean, it is recommended to use water rinse, avoid using irritating lotion.
3, diet should strengthen nutrition, moderate increase the intake of high-protein food and fruits and vegetables, such as milk, eggs, spinach, lettuce, etc.
V. Personal insight
The patient had been diagnosed with uterine fibroids in the past, but did not receive formal treatment because of the absence of specific physical symptoms. Under normal circumstances, it is recommended to send for pathology to clarify the benignity and malignancy of the mass, but the patient refuses the examination due to her own economic and psychological acceptability, so it is recommended to review the ultrasound to avoid recurrence or persistent progression of the fibroids. Therefore, we urge all women to seek medical attention promptly after abnormal changes in their periods and follow medical advice to avoid affecting their health.