Pyomyoma Following Uterine Artery Embolization (UAE) – Dual Case Report and Review of Literature

Rezai, Shadi; Hastings, Andrei Nikolai; Ferreira, Khaldun; Folterman, Christopher; Astill, Nicole; Kolade, Olamide B.; Arampulikan, J.; Elmadjian, Malvina

doi:10.15406/ogij.2016.04.00097

Cited by 6 publications

(15 citation statements)

References 23 publications

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“…Of the 10 cases identified, only 2 presented with malodorous vaginal discharge [10], [12]. Most patients presented with fever, pelvic pain, and leukocytosis [4], [5], [6], [7], [8], [9], [10], [11], [12]. These findings were also consistent with postembolization syndrome, which can occur in up to 21% patients [14].…”

Section: Discussionsupporting

confidence: 57%

“…Though 50 pyomyoma cases were identified since 1945 through a Medline search of the English-language literature [13], only 10 were cases of pyomyoma after uterine embolization [4], [5], [6], [7], [8], [9], [10], [11], [12]. Patient age in the studies ranged from 34 to 65 years.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Furthermore, whereas postembolization syndrome symptoms typically peak at 48 hours postprocedure and abate within a week, the majority of patients reported in the literature were still symptomatic between the first and second weeks post-UFE. In terms of imaging findings, patients with pyomyoma usually showed an enlarged, irregular uterus, heterogeneous tissue appearance, free pelvic fluid, and foci of gas on US, CT or MRI [4], [5], [6], [7], [8], [9], [10], [11], [12]. Nevertheless, these findings can be observed in cases after UFE and are considered a normal process following tissue infarction-desiccation [15].…”

Section: Discussionmentioning

confidence: 99%

“…One extremely rare complication of fibroid embolization is pyomyoma, which is the localized infection of the embolized leiomyoma after developing necrosis. Only 10 cases of pyomyoma after UFE have been reported in the literature and 9 out 10 were treated with hysterectomy [4], [5], [6], [7], [8], [9], [10], [11], [12] The most common presentation of pyomyoma after UFE can be rather nonspecific and mimic postembolization syndrome, with overlapping symptoms of fever, abdominal pain, vaginal discharge, and elevated white blood cells [4], [5], [6], [7], [8], [9], [10], [11], [12]. Therefore, pyomyomas must be diagnosed in a timely fashion to avoid major morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Uterine-sparing management of pyomyoma after uterine fibroid embolization

Gabriel

Hoffman

et al. 2019

Radiology Case Reports

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Uterine fibroid embolization (UFE) is an increasingly popular treatment for uterine fibroids. One extremely rare complication after fibroid embolization is pyomyoma, which is the localized infection of the leiomyoma after embolization. Only 10 cases of pyomyoma after UFE have been reported in the literature. We present a case of delayed submucosal pyomyoma identified on computed tomography after 42 days post-UFE. While the majority of previously reported cases were managed by hysterectomy, our patient was treated with a uterine-sparing hysteroscopic transcervical approach. A high level of clinical suspicion is necessary to diagnose this complication after UFE to avoid major morbidity. Submucosal pyomyomas offer a favorable anatomical location easily accessible by hysteroscopy and a conservative approach may be sufficient to manage this complication.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Uterine-sparing management of pyomyoma after uterine fibroid embolization

Gabriel

Hoffman

et al. 2019

Radiology Case Reports

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Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

Diress

Belsti

Getnet

et al. 2021

BMC Pregnancy Childbirth

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Background Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen’s illiterate “E” chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment. Results A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5–26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1–4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3–4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2–4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2–6.3) had higher chance of visual impairment. Conclusion The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.

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Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

Vulasala

Gopireddy

Mohamed

et al. 2021

JCIS

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Leiomyomas, also termed as fibroids, are benign smooth, muscle neoplasms seen in 70–80% of women by the age of 50 years. Uterine artery embolization (UAE) is a minimally invasive procedure that involves cessation of vascular supply to the fibroids, by infusion of gelatinous microspheres into the uterine arteries. Pyomyoma is a suppurative leiomyoma, secondary to infection of necrotic tissue. It is an infrequent complication of uterine artery embolization (UAE). Pyomyoma can lead to sepsis, peritonitis, and respiratory distress syndrome resulting in high morbidity and mortality. Due to its rarity, high suspicion is crucial in the diagnosis, and prompt treatment is recommended to reduce mortality. Ultrasound, computed tomography, and magnetic resonance imaging assist in diagnosis. We present a case of a 44-year-old woman with ruptured pyomyoma, following an UAE intervention. The patient was treated with total abdominal hysterectomy and salpingo-oophorectomy along with peritoneal irrigation and drainage.

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Pyomyoma Following Uterine Artery Embolization (UAE) – Dual Case Report and Review of Literature

Cited by 6 publications

References 23 publications

Uterine-sparing management of pyomyoma after uterine fibroid embolization

Uterine-sparing management of pyomyoma after uterine fibroid embolization

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

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