Slide 12

To optimize a patient before surgery, it is ideal to schedule the procedure outside of the patient's menstrual period. For larger fibroids, some surgeons give GnRH analogs for a few months to shrink the size. Mesoprostol may also be given to soften the cervix, making it easier for the surgeon to dilate. Prophylactic antibiotics are important to prevent postoperative endometritis in a small percentage of patients. There are a few things we can do to help optimize the patient prior to surgery. Ideally, you want to schedule the procedure and not during the patient's period. Some surgeons like to give their patient GnRH analogs for up to two to three months before the procedure for fibers that are greater than three centimeters. This helps to decrease the size before removal. Some surgeons also like to give their patients mesoprostol before the procedure because it helps with cervical softening, which aids the surgeon in dilating the cervix for the procedure. We also want to give prophylactic antibiotics. This is to limit the postoperative endometritis that is seen in one to five percent of patients.