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A Novel Approach to Management of Symptomatic Myomas in Adolescents

      Background: Large leiomyomas are rare in teenagers, but can be the cause of significant morbidity including pelvic pain, abdominal cramps, abnormal uterine bleeding resulting in anemia. There are both medical and surgical treatment options, but for sizable fibroids a surgical approach is often necessary. For young, nulliparous women preservation of fertility is an important factor when deliberating surgical techniques. Since long-term outcomes and fertility preservation are not well known in the adolescent population for alternative techniques, myomectomy remains the procedure of choice. A significant peri-operative concern with a myomectomy is hemorrhage especially if the patient is already anemic from menorrhagia. Other obstetrical and gynecological operations with the risk of significant blood loss have successfully used uterine artery balloon catheter to control hemorrhage and reduce blood loss. .
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