Quite often, doctors are expected by patients to perform miracles. One such doctor is Gynecologist and Gynecological Endoscopic Surgeon Dr. Prashanth Hegde who recently performed a rare surgery and revealed to HEALTH what it entailed.
Q) In medicine, what is considered a rare case?
Dr. Hegde: A rare case, even though difficult to define, is an uncommon clinical condition which is not routinely/ frequently seen or reported by the doctor on a day-today
practice.
Q) As a doctor, how do you explain to the patient and his/her family the risks and dangers involved in a high risk case?
Dr. Hegde: Medicine is a blend of art and science. A good physician uses his scientific knowledge to diagnose the clinical condition and also applies his communication skills to share the disease related information to patient or his/her family.
A high risk case, as the name suggests, is one where despite the best possible care, there are higher chances of complications in patient care which may result in an
adverse/unexpected outcome. The treating doctor, through an effective counseling session, should explain the benefits and risks associated with the planned treatment without causing undue fear/anxiety in the patient.
Q) In your recent high risk case, what was the patient suffering from?
Dr. Hegde: Ms. X aged 26 years, an unmarried Nigerian woman presented to the hospital with complaints of abdominal pain, painful menstruation, and heavy menstrual bleeding for the past one year. She had visited the US and UK for treatment of this problem. She was found to have a large mass in her abdomen almost mimicking a nine
month pregnancy. She was diagnosed to have large fibroids (super giant leiomyoma) in her uterus or tumor of the womb. She was planned for surgery for the removal of these
tumors from the uterus.
Q) What made this case high risk?
Dr. Hegde: Fibroid uterus (leiomyoma) is relatively a common condition in women in the reproductive age group. Super giant leiomyoma, as in this case, is an uncommon condition posing significant risk during treatment. Surgery for this condition carries the risk of heavy blood loss. Additional risk of damage to the uterus compromising
her future fertility of this young unmarried woman made it much more complex.
Q) What was the most challenging part of this case?
Dr. Hegde: The surgical challenge was to remove the supergiant fibroid preserving the uterus for her future fertility as this surgery usually involves a huge risk of heavy bleeding during the operation. In the event of torrential life threatening bleeding during surgery, we may have to resort to removal of uterus in order to control bleeding to save her life. We overcame these challenges by successfully removing the supergiant leiomyoma (which weighed more than 3000 grams) from her uterus retaining back her fertility.
Q) How is this patient doing today?
Dr. Hegde: The patient had a normal post-operative recovery. Her follow-up visit after a week in the hospital was satisfactory with complete restoration of her health.
