A 30yrs old,para two,with two live children has menorrhagia for 2years ,she was ligated 4yearsback.on investigation she is found to have a 2cm x2cm submucous myoma .what will be the best management option for her
Uterine conditions where hysterectomy should be done compulsary is Menorrhagia Unterine fibromyoma Adenomyosis Tubo ovarian masses Ca.insitu Atypical endometrial hyperplasia Endometriosis Total abdominal hysterectomy: An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen.A paial hysterectomy removes just the uterus, leaving the cervix intact. In cases of cervical low anterior and posterior fibroid and one encroaching into broad ligament ,the bladder, uterus,rectum are displaced from their normal anatomical position and are at risk of injury . In a cervical and huge anterior wall fibroid when the tumor hangs the vaginal vault and is close to the bladder ,it is good to perform myomectomy first .this allows clear the veiw of vaginal vault and prevents bladder injuries Hysterectomy can be safely performance in the lower posterior fibroid conditions Ref Shaw 16/e pg 406
Total abdominal hysterectomy
Danazol 400mg twice daily for 3months
Gn RH analogues
Hysterectomy myoma resection
Anatomy of the female genital tract