A 59-year-old postmenopausal woman who initially sought treatment for persistent nausea was later diagnosed with a massive 2.8 kg fibroid uterus in Mumbai. What appeared to be a routine urinary tract infection turned out to be a serious and silently progressing condition that had already begun affecting her kidneys. The case underscores the importance of regular gynecological
check-ups, especially in postmenopausal women.
Mild Symptoms Reveal a Serious Underlying Condition
The patient reported no abdominal pain, no postmenopausal bleeding, and no obvious gynecological complaints. Doctors initially treated her for a urinary tract infection. However, further evaluation revealed acute pyelonephritis — a kidney infection — caused by ureteric compression. Importantly, a simple per abdomen examination detected a large abdominal mass. A basic gynecological assessment immediately raised suspicion, highlighting how routine clinical examinations can uncover life-threatening conditions at an early stage.
Imaging Confirms Massive Fibroid Uterus
An ultrasound (USG) confirmed the diagnosis. Imaging revealed a massively enlarged fibroid uterus, approximately the size of a 24-week pregnancy. The dominant subserosal fibroid measured nearly 14 cm in diameter. The enlarged uterus had displaced bowel loops and was compressing one of the ureters. As a result, urinary stasis developed, leading to infection and placing the kidney at risk of long-term damage. The final surgical specimen weighed 2.8 kilograms — an unusually large fibroid uterus for a postmenopausal woman.
The patient later admitted that she had noticed gradual abdominal enlargement over the years but assumed it was age-related weight gain. Since she experienced no alarming symptoms, she delayed seeking medical attention, allowing the fibroid to grow silently.
Expert-Led Multidisciplinary Care in Borivali
The case was led by Dr. Hemakshi Mehta, Consultant Obstetrician and Gynaecologist at Apex Superspeciality Hospital. Dr. Mehta and her team approached the case with clinical precision and compassionate care. However, the timing of surgery presented a significant clinical dilemma. Operating during an active kidney infection carried serious risks, including sepsis and
anesthesia-related complications. On the other hand, delaying surgery meant continued ureteric compression and potential worsening of kidney damage.
Staged Treatment Plan Ensures Patient Safety
To balance these risks, the team adopted a carefully staged management strategy. First, doctors stabilized the patient with intensive intravenous antibiotics to control the infection. A nephrologist closely monitored kidney function and infection markers. Meanwhile, anesthesiologists evaluated her overall surgical readiness. This multidisciplinary coordination ensured that all risk factors were addressed before proceeding.
After nearly one month of optimized medical management and complete resolution of infection, the team performed a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy.
Despite the size of the fibroid, surgeons successfully removed the 2.8 kg uterus through a minimally invasive laparoscopic approach. The complex procedure required advanced surgical expertise, detailed preoperative planning, and seamless coordination between gynecology, nephrology, and anesthesia teams. The surgery was completed safely, and the patient experienced a smooth postoperative recovery with preserved kidney function.
Key Takeaway: Postmenopausal Women Must Not Ignore Symptoms
Dr. Hemakshi Mehta emphasized that postmenopausal women should not overlook abdominal distension, urinary changes, or vague systemic symptoms. “Fibroids may grow silently, even after menopause. Regular gynecological evaluations are essential. Early detection allows safer intervention and prevents avoidable complications,” she said.
This case serves as a strong reminder that even mild or non-specific symptoms can signal serious underlying conditions. Timely diagnosis, multidisciplinary care, and early surgical intervention can significantly reduce complications and protect long-term organ function. As per the press release, for postmenopausal women, routine health screenings remain one of the most effective tools for preventing silent but potentially dangerous gynecological conditions.