Abstract
Background:
A deeply placed, cul de sac retroperitoneal myoma in a young nullipara woman is rare and is a surgical nightmare owing to the technical challenge associated with performing a myomectomy in a small limited space without damaging the adjoining structures in the area.
Case:
A 34-year-old nullipara with no sexual exposure developed a large retroperitoneal myoma. She underwent a laparotomic myomectomy. This abdominal myomectomy was performed to remove a 490-g, 13 × 10 × 12–cm, retroperitoneal deep-seated cul de sac leiomyoma. The operation involved using finger-swiping movements and a myoma screw to excise the deeply placed myoma without damaging the patient's uterus and adjoining adnexa.
Results:
This patient's postoperative period was uneventful. After 48 hours, the drain and Foley's catheter, that had been placed during the operation, were removed, and she was discharged. Histopathology confirmed that the tumor was a benign leiomyoma.
Conclusions:
Good preoperative clinical and imaging assessment, along with certain modifications of the standard abdominal myomectomy procedure, can be beneficial when surgically addressing a large, retroperitoneal, deeply placed cul de sac myoma.
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