Our Summary

This research paper discusses a rare and challenging case of cervical myomas (benign tumors in the uterus) in a woman in her 30s who wished to have a baby in the future. She had multiple myomas, two of which were intramural, meaning they were within the walls of the cervix. The woman underwent a surgical procedure called vaginal myomectomy, which is uncommon for this type of myoma. This procedure removed the tumors while keeping the uterus intact. After the surgery, her cervix appeared normal both visually and in ultrasound scans.

FAQs

  1. What is a cervical myoma and how common is it?
  2. What is a vaginal myomectomy and when is it typically used?
  3. Does a vaginal myomectomy allow for future pregnancies and how does it affect the appearance of the cervix?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss with them the potential risks and benefits of the procedure, as well as any alternative treatment options available. It is important for the patient to have a clear understanding of what to expect before, during, and after the surgery in order to make an informed decision about their care. Additionally, the doctor may recommend lifestyle changes or medications to help manage symptoms and improve the success of the surgery.

Suitable For

Patients who are typically recommended myomectomy are those who are experiencing symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on surrounding organs due to the presence of uterine fibroids (myomas). Additionally, patients who desire future fertility and wish to preserve their uterus may also be recommended for myomectomy. This surgical procedure can help alleviate symptoms and improve quality of life for these patients.

Timeline

Before myomectomy:

  • Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder or bowels.
  • Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence and location of the myomas.
  • Patient discusses treatment options with their healthcare provider, including myomectomy as a surgical option.
  • Patient undergoes pre-operative preparations, which may include blood tests, imaging studies, and possibly medication to shrink the myomas.

After myomectomy:

  • Patient undergoes the surgical procedure, which may be performed through a vaginal, laparoscopic, or open abdominal approach.
  • Patient is monitored in the hospital for a period of time post-surgery to ensure there are no complications.
  • Patient may experience pain and discomfort in the days following the surgery, which can be managed with pain medication.
  • Patient is advised to rest and avoid strenuous activities for a period of time to allow for proper healing.
  • Patient follows up with their healthcare provider for post-operative check-ups to monitor recovery and ensure the myomas have been successfully removed.
  • Patient may experience improvements in symptoms such as decreased menstrual bleeding and pelvic pain, and may be able to pursue future pregnancies if desired.

What to Ask Your Doctor

  1. What are the risks and benefits of myomectomy for my specific case?
  2. Will my fertility be affected by the myomectomy procedure?
  3. What is the recovery process like after a myomectomy?
  4. Are there any alternative treatment options for my cervical myomas?
  5. How likely is it for the myomas to grow back after the procedure?
  6. Will I still be able to have a normal pregnancy after the myomectomy?
  7. How long do you recommend waiting before trying to conceive after the myomectomy?
  8. Are there any lifestyle changes or precautions I should take after the procedure to prevent recurrence of myomas?
  9. What are the potential complications or side effects of a myomectomy?
  10. How often will I need to follow up with you after the myomectomy surgery?

Reference

Authors: Cerqueira L, Pinto PV, Bernardes J, Martinho M. Journal: BMJ Case Rep. 2025 May 5;18(5):e264879. doi: 10.1136/bcr-2025-264879. PMID: 40324940