Table 10 Options in intended fibroid morcellation
Options and considerations | Â |
|---|---|
Informed consent by the patient is the corner stone of preoperative workup. If fibroid morcellation is intended, include its possible complications in the informed consent procedure before operation. | Good practice point |
Standardise the clinical management by using a flowchart to classify patients according to global risk of a sarcoma in a presumed fibroid. Use flowchart in the figure as an option. | Good practice point |
Use transvaginal ultrasound, transabdominal ultrasound or in case of poor visualisation on ultrasound MRI with or without contrast (Gadolinium-DTPA) | D |
Consider including vascularity parameters (RI and PSV in 2D PowerDoppler ultrasound (PDUS) or vascular indices in 3D PDUS) | D |
Consider performing LDH and iso-enzyme 3 assay | D |
Perform a preoperative endometrial aspiration in case of abnormal uterine bleeding | D |
Support the development of potentially beneficial techniques to prevent morcellation complications by participating in clinical trials | Good practice point |
Register patient’s data after her consent including pre-surgery images and post-surgery histology | Good practice point |