Five years ago, she had to have 48 uterine fibroids removed in a surgery.
When the woman, 29, from Delhi started getting abdominal pains again, she suspected something was wrong.
By and by, her stomach grew to the size of a seven-month pregnant lady.
The fibroids were back.
This time, there were 106 of them.
In a rare and complex surgery that lasted four hours, doctors at the BLK-Max Super Speciality Hospital removed them, 10 at a time, with 11 blood transfusions along the way.
Uterine fibroids are slow-growing benign tumors.
They are not uncommon and it is only when there are too many or they are too large that they cause observable symptoms like heavy periods, anaemia, enlarged uterus and anxiety.
“It is extremely rare to have so many fibroids.
Surgical removal is considered when they cause extremely heavy and painful periods, cause difficulty in conceiving or lead to miscarriage,” said Dr Neha Khandelwal, a gynaecologist at the Rainbow Madhukar Hospital.
In this case, Dr Dinesh Kansal, the lead surgeon said, “The patient did not come back for follow-ups after the first surgery.
That led to her developing multiple fibroids over the years.” When she started exhibiting symptoms, Kansal suggested hysterectomy, removal of the uterus.
It’s difficult to remove fibroids surgically and they always come back.
“But she is unmarried and did not want to lose her chance to conceive.” Fibroids cause anaemia and her haemoglobin levels were down to 5 grams per decilitre.
So, the doctors had to first stop her periods, give her iron supplements and then wait.
It took a month for her haemoglobin to go up to the normal 12 grams per decilitre.
The surgeons were ready to go.
The patient’s bowels and rectum were moved away carefully so that they didn’t get damaged.
Then, a number of cuts were made on the uterus.
Through each small cut, they had to remove eight to ten fibroids and suture it back.
“The biggest challenges were possible bowel damage and blood loss,” said Kansal.
“There was a risk of excessive bleeding because we had made so many cuts.” It took four hours and 11 blood transfusions.
After the surgery, the patient was in the ICU for a while and discharged in six days.
But the patient’s chances of conceiving are not very bright, Kansal said.
“Even if she gets pregnant, she may have to undergo a premature C-section for delivery.”