- This rare case involving a middle-aged Omani woman highlights the importance of early diagnosis and timely gynaecological care
- Uterine fibroids are among the most common gynaecological conditions affecting women, particularly between the ages of 25 and 50 with international estimates suggesting 70–80% of women will have fibroids by age 50 [1]
- Dr. Azza Gouda, at Medcare Women & Children Hospital, successfully removed 44 fibroids while preserving the patient’s uterus since the patient was keen to keep her uterus intact.
Dubai, : Medcare Women & Children Hospital (MWCH) in Dubai successfully treated a 47-year-old Omani woman after Dr. Azza Gouda Ibrahim, Head of the Obstetrics & Gynaecology Department, discovered 44 uterine fibroids that had significantly altered the shape of her uterus, causing persistent pelvic pain, abnormal bleeding and considerable discomfort.
The patient travelled from Oman to Dubai after experiencing months of escalating symptoms, including ongoing pelvic pain and irregular vaginal bleeding that worsened during her menstrual cycles. The enlarged uterus and extensive number of fibroids were causing continuous pressure and discomfort, significantly affecting her daily life. A thorough evaluation, which included a pelvic ultrasound, uncovered numerous fibroids that were difficult to count. Understanding how important it was for the patient to preserve her uterus, Dr. Azza recommended a surgical approach focused solely on removing the fibroids while keeping the uterus intact. When the procedure took place, doctors discovered the full extent of the situation; there were actually 44 fibroids of varying sizes in the patient’s uterus.
“What made this case remarkable was the sheer number of fibroids. We often treat women with fibroids, but finding 44 separate growths in one uterus is extremely unusual. Individually, they were relatively different in sizes, but together they had created a much bigger problem, causing persistent pain, bleeding and pressure that was affecting the patient’s everyday life. It is a powerful example of why the number and location of fibroids can sometimes matter just as much as their size,” said Dr. Azza Gouda Ibrahim, Head of the Obstetrics & Gynaecology Department and Consultant Obstetrics & Gynaecology at Medcare Women & Children Hospital, who led the surgical procedure.
While many fibroid cases can be managed using minimally invasive keyhole techniques, the unusually high number and distribution of fibroids made this case considerably more complex. During the assessment and management of the case, the medical team also discovered blood collected within the abdominal cavity, adding another level of complexity and requiring careful management of the associated bleeding.
The team proceeded with an open surgical approach known as a laparotomy, providing greater access and visibility to fully assess the pelvis, control the bleeding and remove the extensive number of fibroids with precision while protecting the surrounding structures. During the surgery, the team also performed bilateral uterine artery ligation, a technique used to significantly reduce blood flow to the uterus and help control bleeding during the procedure. Despite the extent and complexity of the condition, doctors were able to successfully remove the fibroids while preserving the patient’s uterus as the patient had requested.
“If left untreated, her symptoms would likely have continued to worsen, increasing the risk of ongoing bleeding, chronic pain, anaemia and further enlargement of the uterus. Our priority was to safely treat the condition while preserving the uterus as per the request of the patient, and we were able to achieve that,” Dr. Azza explained. The procedure successfully addressed the underlying cause of the patient’s symptoms. Following surgery, the patient remained in hospital for seven days for postoperative care and observation before being safely discharged. Having travelled from Oman for the treatment, she subsequently returned home and was able to resume her normal daily activities post her return.
The case also highlights a wider concern in women’s health, symptoms such as heavy periods, persistent pelvic pain and abdominal swelling can sometimes be dismissed as a normal part of menstruation or ageing. Delaying assessment, however, may allow an underlying condition to progress and potentially make treatment more complex. “This case reinforces an important message in women’s health – early assessment and detection matters. As healthcare providers, we need to continue encouraging women to recognise changes in their bodies and seek medical advice rather than normalising persistent pain or symptoms. Earlier diagnosis can make a meaningful difference in how conditions are managed and, ultimately, in patient outcomes,” said Dr. Ahmed Abdelhameed, Medical Director at Medcare Women & Children Hospital.
Uterine fibroids are considered to be one of the most widespread gynaecological conditions impacting women, especially those aged 25 – 50 years old. Global research indicates that by age 50, approximately 70–80% of women will experience fibroids at some point in their lives.
Many women can have fibroids without experiencing any symptoms at all. When symptoms do occur, however, warning signs can include heavy or prolonged menstrual bleeding, severe menstrual pain, persistent pelvic pain or pressure, abdominal swelling or bloating, frequent urination, constipation, pain during intercourse, and unexplained anaemia or fatigue. These symptoms do not necessarily indicate fibroids, but persistent or worsening changes should be assessed by a gynaecologist. Early evaluation can help identify the underlying cause and give women access to a broader range of treatment options before a condition becomes more difficult to manage.