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Abstract: Ms. Jiang, 39, was found to have uterine smooth fibroids 10 years ago after giving birth, but she did not pay attention to it and did not receive regular review. When she visited our hospital again in June this year, she already had symptoms of abdominal distension and pain, increased menstrual flow, prolonged menstruation and menstrual weakness. She was treated with cefmetazole sodium for injection after the operation, and her condition improved after the treatment.
Basic information】Female, 39 years old
Disease Type】Uterine smooth muscle tumor
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】June 2022
Treatment plan】Surgical treatment (myomectomy) + intravenous infusion (cefmetazole sodium for injection)
Treatment period】5 days of hospitalization, 1 month after discharge for review
Treatment effect】The fibroids were completely removed and the examination results returned to normal.
I. Initial consultation
A 39-year-old Ms. Jiang came to our hospital complaining of increased menstruation after childbirth 10 years ago, and her uterus was found to have a hypoechoic mass with uneven enlargement by ultrasound examination. She was diagnosed with uterine smooth muscle tumor without any other organ abnormalities. Since the fibroids were small in size and the clinical symptoms were not serious, she was instructed to review them regularly. However, she did not come to the hospital for review afterwards, and then came to our hospital again in June this year, complaining of heavy menstrual flow, a feeling of distension and pain in the abdomen, and more bleeding during menstruation than before, and the sanitary napkin would be soaked through every time she had her period, especially on the second day of menstruation when the bleeding was more severe. At the same time, her menstrual cycle was prolonged, and she often had symptoms of anemia with weakness and fatigue during her period. This time, she was found to have a large uterine smooth muscle tumor by 4-dimensional color Doppler ultrasonography, and was admitted to our hospital for treatment of “uterine smooth muscle tumor”.
II. Treatment history
The patient was diagnosed with abnormal uterine bleeding, and surgery was indicated due to uterine fibroids, but segmental scraping was needed to exclude endometrial lesions. The patient was a 39-year-old woman and could be treated by resection of the fibroids. Because of the large fibroids and their location in the posterior wall, the surgical route was recommended to be open. Ms. Jiang was informed that she could be treated by surgical means and she agreed. After preoperative examination and exclusion of contraindications to surgery, she underwent open myomectomy. The operation went smoothly, with minimal bleeding after rapid suture removal of the myoma.
III. Treatment effect
After 4 days of hospitalization, 4-dimensional color Doppler ultrasonography revealed that the hypoechoic mass inside the uterus disappeared, and the uterine shape became normal in volume and proportional in shape. After 6 days of hospitalization, the surgical incision was completely healed and Ms. Jiang told me that the abdominal distension and pain had disappeared. One month after discharge, Ms. Jiang returned to the hospital for a follow-up examination and told me that her menstrual volume and cycle had returned to normal, and that she did not experience fatigue or tiredness during her menstrual period, and that her ultrasound examination results were normal.
IV. Precautions
I am glad that Ms. Jiang’s condition has improved after the myomectomy and she is in good health. However, since the cause of uterine fibroids may be related to hormonal changes, Ms. Jiang needs to pay attention to avoid taking sex hormone drugs and eating foods with high hormone levels as much as possible after her discharge from the hospital, and pay attention to eating foods rich in protein, minerals and other nutrients, such as eggs and Lean meat, etc., can help the body recover. You should communicate with others more often and keep a happy mood, which is also good for your health. If abnormal increase in menstrual flow occurs again after discharge from the hospital, it is recommended to return to the hospital in time for treatment.
V. Personal insight
Uterine smooth muscle tumor is a benign tumor. When Ms. Jiang first developed the tumor, there was no need for treatment because the size of the tumor was small and the clinical manifestations were few. However, it is crucial to receive regular review so that if there is a tendency for the tumor to become larger, it can be treated in time. However, Ms. Jiang did not pay attention to the initial onset of the disease and did not return to the hospital for regular review, which led to a significant increase in the size of the tumor, causing significant discomfort to her body and even inducing anemia. At this point, only surgical treatment could be taken to prevent more serious harm from occurring.