Hysterectomy: treatment for secondary infertility

Area of Science:

• Reproductive Medicine
• Surgical Gynecology

Background:

• A 30-year-old woman presented with secondary infertility, a large abdominal mass, and severe pain following obstructed labor.
• She had a history of vesicovaginal fistula (VVF) repair and vaginoplasty, yet desired fertility.

Observation:

• The patient experienced significant distress from abdominal pain and sought a definitive cure.
• Management presented a dilemma: attempting fertility-sparing procedures carried high risks of VVF repair damage and treatment failure.

Findings:

• Exploratory laparotomy was performed, leading to a total abdominal hysterectomy.
• The decision prioritized alleviating the patient's pain and addressing the abdominal mass.

Implications:

• This case highlights the complex ethical and clinical considerations in managing infertility in patients with severe obstetric sequelae.
• Adoption was discussed as a viable alternative for childbearing, underscoring a multidisciplinary approach to reproductive challenges.