Please be advised that the images below are graphic in nature.
3 Goldberg boys born following myomectomy
53 fibroids removed from a patient with a 20 week uterus causing severe anemia to a hemoglobin of 3
16 fibroids removed at myomectomy in patient wishing to avoid hysterectomy
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26 week uterus causing severe bulk symptoms treated with supracervical hysterectomy with minimal blood loss.
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28 week size fibroid uterus causing severe hydroureter and hydronephrosis seen on MRI
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Decompressive myomectomy to facilitate hysterectomy
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Large fibroid at uterine cornua
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Endometrial Polyp
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| Kruckenberg tumor masquerading as pedunculated fibroid |
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A patient with ultrasound and MRI diagnosed large pedunculated fibroid was found instead to have a solid ovarian mass adherent
to the uterus. The mass was excised at the time! of a planned myomectomy. Pathology found signet ring cell carcinom a , which
had metastasized from the GI tract to the ovary (Kruckenberg tumor).
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| Large intramural fibroid |
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15 cm intramural (within the wall) fibroid causing pelvic pain, heavy menses, and abdominal distension being removed during
myomectomy.
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Uterus reconstructed after removing large intramural fibroid |
| Asymptomatic Fibroid Uterus |
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Seen at the time of laparoscopic tubal ligation with cautery. |
| Submucosal Fibroid |
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Submucosal fibroid seen on ahysteroscopy in a woman with menometrorrhagia (prolonged heave vaginal bleeding). |
| Patient with Fibroid and Adenomyosis |
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1. 16 week size uterus causing pelvic pressure, painful menses, and urinary frequency. Multiple fibroids were seen on ultrasound.
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2 & 3. 11 small fibroids were removed, however, the majority of the uterine volume remained due to adenomyosis. Given the
patient's desire for future fertility a hysterectomy was not an option.
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| Adenomyosis |
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1 & 2. 36-year-old woman with chronic pelvic pain and dyspareunia (painful intercourse). Her examination was notable for a
firm, slightly enlarged, tender uterus. Pelvic ultrasound was suspicious for adenomyosis. A vaginal hysterectomy revealed
adenomyosis infiltrating the entire myometrium.
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3 - Residual Adenomyosis seen following removal of multiple fibroids
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| Dense Adhesions from a Prior Myomectomy |
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1 & 2. Patient with a 30+ week size fibroid uterus, who had previously undergone myomectomy. A repeat myomectomy was attempted
due to bulk symptoms and desire for fertility. At surgery, her bowel was densely adherent to the entire uterine surface. Additionally,
one of the broad ligaments, with a large vascular supply, and adnexa (fallopian tube and ovary) was densely adherent and stretched
thin over the large uterine surface.
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Cesarean Section
A 30-year-old woman, who underwent two myomectomies, had a scheduled cesarean section at 39 weeks gestation. Her antenatal
ultrasound demonstrated seven fibroids, ranging from 6 to 10 cm.
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1 - A classical (vertical) uterine incision was required due to the location of the fibroids. Numerous small fibroids not
found on the ultrasound are seen in the incision.
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2 - Baby being delivered through the uterine incision. |
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3 - A healthy 8 pound baby boy. Due to the numerous fibroids and the classical uterine incision, the mother has a 3000 cc
blood loss. She was transfused 2 units of packed red blood cells during the surgery. Her recovery was uneventful.
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| Fibroid Photos |
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1 - abdomen of woman with 28 week sized uterus prior to myomectomy |
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2 - 28 week sized uterus delivered through abdominal incision prior to myomectomy. A cantaloupe sized cervical fibroid was
found in addition to 14 others
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3 - Myomectomy being performed on 28 week uterus with large cervical fibroid. Ovary and tube seen laterally |
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4 - Posterior view after myomectomy removed 14 fibroids from the uterine corpus. Reconstructed uterus (above marked line)
is seen above cantaloupe sized cervical fibroid
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5 - Lipoleiomyoma (Fatty Fibroid) pathology specimen |
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Vaginal Hysterectomy Photos
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1 - cervix prolapsing through vaginal introitus grasped by tenaculi |
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2 - cervix being bivalved with scalpel |
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3 - uterine corpus being bivalved after separation of cervix has been completed |
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4 - uterus halved after bivalving procedure to facilitate its removal |
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5 - after half of uterus is removed. cervix is grasped with uterine corpus below |
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6 - following procedure bladder is drained with foley catheter revealing non-bloody urine |
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7 - removed uterus sent for pathology examination |
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8 - 30 Fibroid Myomectomy |
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9 - Pelvic abcess following vaginal hysterectomy |
| Baby Delivery Photos |
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Baby Aden being delivered via cesarean section by Dr. Thomas Klein and Dr. Cheung Kim. His mother had previously undergone
myomectomy at Jefferson to remove multiple uterine fibroids, the largest 14 cm, which had caused two pregnancy losses, pelvic
pressure, and urinary frequency. This was her third baby delivered since her myomectomy.
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Dr. Goldberg delivering a baby via cesarean section. The mother previously underwent myomectomy through the Jefferson Fibroid
Center to remove multiple uterine fibroids, which were causing infertility. This was her second baby delivered following her
myomectomy.
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| Fibroid Photos |
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17 cm pedunculated fundal fibroid |
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14 cm fibroid causing pelvic pressure and menorrhagia (heavy bleeding) |
| Cesarean Section with & without Fibroids |
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Uterus with multiple fibroids at time of cesarean section after delivery of term infant. |
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Non-fibroid uterus at time of cesarean section after delivery of term infant. |
| 40 Week Sized Myomectomy |
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View of patient with 40 gestational week size uterus at laparotomy for myomectomy. Large basketball size fluid filled degenerating
fibroid at left ruptured while delivering it through the incision. 31 fibroids were removed with minimal blood loss.
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31 fibroids removed from 40 gestational week size uterus at myomectomy. |
| 33 Week Sized Fibroid Uterus |
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Dr. Sheila Kambin with 33-week sized fibroid uterus elevated through a vertical skin incision |
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Lateral view of 33-week sized uterus elevated through a vertical skin incision |
| Myomectomy for Infertility |
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Myomectomy being performed for an 8 cm fibroid which distorted the uterine cavity causing infertility.
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| Pedunculated fibroid with adhesions to omentum |
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Lysing omentum adhesed to pedunculated fibroid |
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Pedunculated fundal fibroid |
| Posterior cervical fibroid |
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Large posterior lower cervical fibroid (grasped with towel clamp) |
| Subserosal Fibroids |
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Subserosal fibroids image |
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Subserosal fibroids specimen |
