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Nascent myoma as a cause of urinary retention


Authors: M. Tomanová;  I. Semerádová;  I. Lukáčová
Authors‘ workplace: Gynekologicko-porodnické oddělení, Nemocnice AGEL Ostrava-Vítkovice a. s.
Published in: Ceska Gynekol 2023; 88(5): 372-375
Category: Case Report
doi: https://doi.org/10.48095/cccg2023372

Overview

We present the case of a 47-year-old woman with a bulky, nascent necrotic myoma, which at first glance appeared to be a malignant process in the cervix. It caused significant retention of urine due to compression of the bladder and ureters, hydronephrosis and deterioration of renal function. A fully developed picture of the “bulge syndrome” dominated – lymphedema of the lower limbs and lower abdomen, pain in the lower abdomen, constipation, secondary secondary urinary infection, and paradoxical ischuria. During a gynecological examination in a specula, a strong-smelling, necrotic tumour was visualized reaching half of the vagina, which was causing a bloody discharge, which brought the patient to the examination. A biopsy was taken from the tumour. A permanent urinary catheter was inserted into the urinary bladder with gradual adjustment of renal functions. Due to the difficulties and the benign histological findings from the biopsy, a simple abdominal hysterectomy with bilateral salpingectomy from a lower midline incision was indicated. The operation was complicated by an extensive adhesive process and blood loss of 1,200 mL, with a decrease in hemoglobin in the blood count from 128 g/L to 79 g/L and the need for three blood transfusions. In the postoperative period, there is a prompt recovery of spontaneous micturition with normalization of bladder function, subsidence of lymphedema and subjective complaints of the patient.

Keywords:

Hysterectomy – urinary retention – myoma – bulky diseases – nascent uterine myoma


Sources

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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 5

2023 Issue 5

Most read in this issue
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