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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
EXPERIENCE WITH PFANNENSTIEL INCISION FOR VERY LARGE UTERINE FIBROIDS
Author
Ojabo AO*1, Adesiyun AG2, Hembah-Hilekaan SK1, Ameh N2, Hajaratu Umar2, Mohammed-Durosinlorun A2
Email
austinojabo@yahoo.co.uk
keyword
Very large uterine fibroids, Pfannenstiel incision, Midline incisions, Myoma, Menorrhagia, Laparotomy.
Abstract
Objective: Very large uterine fibroids are common in young, nulliparous African women and they often require surgical intervention to treat symptoms. Midline abdominal incisions rather than the cosmetically superior and stronger Pfannenstiel incisions are used. This article aims to describe Pfannenstiel incision for selected cases of fibroids complicated by very large sizes without externalizing the uterus. Methods: This a descriptive observational study demonstrating in brief the surgical technique of abdominal myomectomy while the uterus is in-situ for selected cases of fibroids complicated by very large size through a standard Pfannenstiel incision, instead of using the traditional midline abdominal incision to improve accessibility. It also involves applying a rubber tourniquet to the isthmus of the uterus without first exteriorizing the uterus. Results: Our experience with 36 cases over a three year period is described. The average age of the patients was 33.6 years and uterine sizes ranged from 16-28 weeks of gestation with a median of 18 weeks. The median intra-operative blood loss was 350mls with no patient requiring blood transfusion. Operation time was not significantly increased and there was no major intra-operative complication. Conclusion: This study have shown that women with very large uterine fibroids can benefit from Pfannenstiel incision with all the advantages it confers without increasing the risk associated with abdominal myomectomy and also avoid the less cosmetically attractive midline abdominal incision.
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