Surgical Treatment of Enlarged Cervical Leiomyoma with Concomitant Uterine Prolapse: A Case Report

This case report details the surgical treatment of a rare enlarged cervical leiomyoma with uterine prolapse in a 48-year-old woman. She presented to Konyang University Hospital with a palpable vaginal mass, lower abdominal pain, and urinary incontinence. Despite being nulliparous, she had severe chr...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-07, Vol.13 (14), p.4210
Main Authors: Song, Ah-Yun, Bae, Ju-Young, Park, Jin-Sol, Kim, Tae-Hyun
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Asymptomatic
Bladder
Case reports
Cervix
Constipation
Fibroids
Health facilities
Hysterectomy
Infections
Ligaments
Pelvis
Robotics
Robots
Surgery
Urinary incontinence
Urinary retention
Urology
Uterus
Vagina
Women
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Summary:This case report details the surgical treatment of a rare enlarged cervical leiomyoma with uterine prolapse in a 48-year-old woman. She presented to Konyang University Hospital with a palpable vaginal mass, lower abdominal pain, and urinary incontinence. Despite being nulliparous, she had severe chronic constipation due to schizophrenia medication and lived in a health care facility separated from her family. Pelvic examination revealed stage 3 uterine prolapse with a large necrotic cervical leiomyoma. A robot-assisted vaginal hysterectomy followed by sacrocolpopexy was performed using the Da Vinci Xi Surgical System. Histopathology confirmed cervical leiomyoma with squamous metaplasia. At a three-month follow-up, there were no complications, pelvic anatomy was restored, and urinary incontinence improved. Although the patient had a systemic infection due to the necrotic cervical leiomyoma, raising concerns about the increased risk of infection associated with mesh use, she was high-risk for pelvic organ prolapse (POP) recurrence due to her medical history and living situation. Therefore, she underwent concurrent surgeries with pre- and postoperative antibiotic treatment, and recovered without complications. Given that the risk of developing POP increases after a hysterectomy, in high-risk patients, as demonstrated in this case, the concurrent surgical correction of POP may be an effective strategy.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13144210