Background:
Some of submucosal myomas may be pedunculated and eventually can protrude through the cervical canal or even into the vagina. The diagnosis, evaluation and treatment of prolapsed pedunculated submucous myoma may need vaginal access compromising sometimes the hymenal integrity.
Case report:
21-year-old, nulliparous virgin Turkish Muslim woman admitted to our clinic in February 2021 with complaint of vaginal bleeding, pelvic pain and palpable mass in the vulva. During the examination, a 5-6 cm mass was observed protruding from the vagina (Fig1).
MRI was performed to evaluate the structure and origin of the mass (Fig2).
The pedunculated myoma was grasped with Pozzi tweezers under direct vision and was removed by ligation and section of the pedicle. In the hymen examination of the patient after the operation, there was a tear extending to the base at 9 o'clock.
Conclusion:
Virginity, defined as an intact hymen has an undeniable value in the Middle Eastern culture. Laparoscopic management of a pedunculated submucous myoma in Middle Eastern virgin patients a safe alternative to laparotomy. Delayed in the diagnosis of the patient caused such undesirable social and psychological problems.
Virgo patients' avoidance of vaginal examination causes serious problems for doctors. Patients who describe menorrhagia and vaginal fullness are recommended to be examined more detailed with USG and MRI.
Anahtar Kelimeler: Hymen, hymenal integrity, leiomyoma
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