Clinical Background: A 63 year old patient who is para two presented with a significant urinary residual volume of 1.1L and unilateral hydronephrosis (swelling of the kidney) and uterine prolapse. A pelvic ultrasound showed multiple uterine fibroids.
Procedure: Patient underwent a total laparoscopic hysterectomy (keyhole surgery), bilateral salpingo-oophorectomy (both ovaries and tubes removed), morcellation of the uterus and fibroids in an Espinar bag (uterus and fibroids were cut into small pieces in a bag to facilitate removal through keyhole surgery) followed by prolapse repair. Operative findings were of a fibroid on the cervix, multiple uterine fibroids and a large bladder prolapse.
Histopathology: Benign cervical and uterine fibroids were confirmed.
Postop: Patient recovered well from her surgery. All laparoscopic wounds have healed with no evidence of recurrence of her prolapse. Her urinary retention has resolved as well.