Skip to main content Accessibility help
×
Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T00:21:56.251Z Has data issue: false hasContentIssue false

Case 24 - A 42-Year-Old G2P2 Woman Undergoing Vaginal Hysterectomy with Difficulty Entering the Peritoneum

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
Get access

Summary

A 42-year-old woman, gravida 2, para 2, last menstrual period three weeks ago, presents for surgical consultation secondary to heavy menstrual bleeding. She reports persistent, regular monthly bleeding with passage of clots. She was admitted to the hospital for a blood transfusion secondary to anemia, dizziness, and fatigue. She was discharged on a progestational agent and reports initial improvement in her bleeding and symptoms. The heavy vaginal bleeding has recurred and is now associated with constant pelvic pain and cramping. She is sexually active with her husband. She is requesting a hysterectomy. She has no relevant past medical or surgical history. She is currently taking medroxyprogesterone (Provera) 20 mg PO three times daily and has no known drug allergies.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 67 - 69
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarts, JW, Nieboer, TE, Johnson, N, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015; 2015(8): CD003677. doi: 10.1002/14651858.cd003677.pub5.Google ScholarPubMed
Committee Opinion No 701: Choosing the route of hysterectomy for benign disease. Obstet Gynecol 2017; 129(6): e155–9.Google Scholar
Occhino, J, Gebhart, J. Difficult vaginal hysterectomy. Clin Obstet Gynecol 2010; 53(1): 4050.CrossRefGoogle ScholarPubMed
Reiffenstuhl, G. The clinical significance of the connective tissue places and spaces. Clin Obstet Gynecol 1982; 25: 811–20.CrossRefGoogle Scholar
Kovac, SR. A technique for reducing the risk of unintentional cystotomy during vaginal hysterectomy. J Pelvic Surg 1999; 5(1): 32–5.Google Scholar
Balgobin, S, Hamid, CA, Carrick, KS, et al. Distance from cervicovaginal junction to anterior peritoneal reflection measured during vaginal hysterectomy. Obstet Gynecol 2016; 128(4): 863–7.CrossRefGoogle ScholarPubMed
Fashokun, TB, Handa, VL. Vaginal hysterectomy. In: Handa, VL, Van Le, L, eds., Te Linde’s Operative Gynecology, 12th ed. Philadelphia: Lippincott Williams & Wilkins. 2020; 352–60.Google Scholar
Nichols, DH, Randall, CL. Vaginal Surgery, 4th ed. Philadelphia: Williams & Wilkins; 1996.Google ScholarPubMed
Heaney, NS. Vaginal hysterectomy – its indications and technique. Am J Surg 1940; 48(1): 284–8.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×