Coagulopathies, including VWD, should always be suspected in patients with refractory AUB. Preoperative medication such as cryoprecipitate products and DDAVP could be given to provide an immediate hemostatic response in preventing excessive bleeding during surgery. Laparoscopy is considered the best surgical approach to ensure less blood loss and lower risk of hemorrhage. A multidisciplinary approach is essential to ensure both effective hemostatic control and comprehensive patient care.
Hiksas et al. (Thu,) studied this question.