Spontaneous Membranous Dysmenorrhea in an Adolescent Girl: A Case Report and Literature Review.

BACKGROUND: Membranous dysmenorrhea is a rare entity. It involves the sloughing of the endometrium in 1 cylindrical or membranous piece, retaining the shape of the uterine cavity. Herein, we report the first case of spontaneous membranous dysmenorrhea in an adolescent girl. CASE: A 17-year-old girl was admitted to the emergency clinic with severe painful menstrual bleeding and passage of tissue via the vagina. Bloody endometrial tissue resembling the endometrial cavity expulsed from the vagina was seen on inspection. The pathologic diagnosis of the mass was membranous dysmenorrhea. SUMMARY AND CONCLUSION: To our knowledge, this is the first case of the spontaneous occurrence of membranous dysmenorrhea. The relationship between membranous dysmenorrhea and endogenous or exogenous progesterone should be investigated further. A review of the literature on membranous dysmenorrhea is presented.

Outcomes after cesarean myomectomy versus cesarean alone among pregnant women with uterine leiomyomas.

OBJECTIVE: To determine whether myomectomy during cesarean delivery is safe and feasible among pregnant women with leiomyomas. METHODS: In a retrospective study, data were reviewed from pregnant women with uterine leiomyomas who delivered by cesarean at a center in Turkey between May 1, 2007, and April 30, 2014. Women were divided into two groups: cesarean myomectomy (CM) or cesarean only (CO). Data were analyzed for characteristics of the uterine leiomyomas, hematologic changes occurring between the preoperative and postoperative periods, duration of the operation, and length of hospital stay. RESULTS: Overall, 76 women formed the CM group and 60 formed the CO group. The mean diameter of the leiomyomas did not differ between CM and CO groups (4.6±2.5cm vs 5.2±2.2cm; P=0.175). More patients in the CM group than in the CO group had subserous (24 [31.6%] vs 7 [11.7%]; P=0.006) and uterine corpus (57 [75.0%] vs 30 [50.0%]; P=0.003) leiomyomas. Fewer patients in the CM group had intramural (44 [57.9%] vs 49 [81.7%]; P=0.003) and fundal (15 [19.7%] vs 25 [41.7%]; P=0.005) leiomyomas. CONCLUSION: Surgeons were more likely to remove corporal and subserous leiomyomas than other types; size did not seem to affect decision making. CM can be a safe operation for some patients.