EXPLAIN: SUBMUCOSAL UTERINE MYOMA

CONTENT: TCR-MYOMECTOMY

Clinical Information:

A {{Pre-menopause, Peri-menopause with HRT treatment, Menopaused without HRT treatment, Menopaused with HRT treatment}} patient,

Major symptoms and signs:

Uterine bleeding: [[Menorrhagia, Hypomenorrhea, Eumenorrhea, Persistent spotting, Irregular bleeding]]

Pain: [[Dysmenorrhea, Chronic pelvic pain, Flank soreness, Low back pain, with radiation to leg]]

Hb:_______

Sonography:

Uterus: {{Grossly normal, There are/is _____ myomata measuring up to _____ cm, Adenomyosis measuring up to ______cm.}}

Endometrial thickness: ______ mm

Right adnexa: {{Normal size, mass measuring up to ____ cm}}

Left adnexa: {{Normal size, mass measuring up to ____ cm]]

Hysteroscopic impression: {{One, Two, Multiple}} [[submucosal myoma, with EM polyps]]

Operative Procedures:

Type of operation: Transcervical resectoscopic myomectomy. (TCR-Myomectomy)

The patient was placed in the dorsal lithotomy position with both legs wrapped with elastic bandage. The patient was placed in the Trendelenberg position, carefully sterilized, and properly draped.

The vagina was opened with speculum, the cervix was properly dilated, then the well assembled resectoscope was put into the uterine cavity. After a thorough survey of the uterine cavity, the submucosal myoma/ emdometrial polyps were revealed, and were later completely resected piece by piece by the electro-cutting loop. Then the bleeding was stopped with the roller-ball coagulator. Finally a small Folly catheter was inserted into the uterine cavity to avoid the adhesion formation.

The patient was sent to POR for recovery and respiratory support. The patient stood the procedure well and was in stable condition.

Operative Finding:

Exocervix: {{smooth, eroded}}

Endocervic and Isthmus: dilatation with Hegar dilator up to #_____

Uterine cavity: Sounding _____cm, with {{One, Two, Multiple}} [[submucosal myoma, with EM polyps]] on [[anterior, posterior, fundal, right lateral, left lateral]] wall, the largest one measuring up to ____ cm.

Right tubal ostium: {{Seen, Obscure}} Left tubal ostium: {{Seen, Obscure}}

Additional EM ablation: {{Nil, with TCRE, with roller ball only}}

Complication: [[Uterine perforation, Water intoxication, Massive bleeding, Bladder injury, Bowel injury, __________________ ]]

Pathology:

Dr:_______________________ Date:______________________