Nascent myoma as a cause of urinary retention
Language English Country Czech Republic Media print
Document type Case Reports, Journal Article
PubMed
37932054
DOI
10.48095/cccg2023372
PII: 135552
Knihovny.cz E-resources
- Keywords
- Hysterectomy, bulky diseases, myoma, nascent uterine myoma, urinary retention,
- MeSH
- Hysterectomy adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymphedema * MeSH
- Urinary Bladder MeSH
- Myoma * complications surgery MeSH
- Urinary Retention * complications surgery MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
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.
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