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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© 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
