Hi, I want to know advice for my patient 45 year 6 months female came with complain of heavy bleeding only in one cycle but her cycles are regular, stress incontinence and chronic constipation. On examination cervix visualized with difficulty but normal looking, cystocele and rectocele grade1, on bimanual exam exact size of uterus not made out, solid mass felt in pod.
On TVS uterus was normal size, ET 5mm, in left lateral aspect of cervix posteriorly one subserous fibroid 3.9 x 3.4 present, bilateral ovaries normal, pap smear shows inflammatory lesion, negative for any malignancy.I advised her to maintain menstrual calender for few months and tranexamic acid during period if heavy bleeding, pelvic floor exercises, lactulose a,d if heavy bleeding persist thn endometrial biopsy, she had 2 NVD and 1CS.
