Unusual complication after uterine artery embolization and laparoscopic myomectomy in a woman wishing to preserve future fertility

Donnez, Olivier; Jadoul, Pascale; Squifflet, Jean; Donnez, Jacques

doi:10.1016/j.fertnstert.2008.05.091

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…Donnez et al published the case of a woman who had uterine scar dehiscence after myomectomy preceded by uterine artery embolization (UAE) 8 . According to this study, UAE can be associated with reduced blood supply and can interrupt myometrial healing of the uterine scar.…”

Section: Discussionmentioning

confidence: 92%

“…Both myomectomy and cesarean section can leave scars in the uterus 5,6 . Such scarring may cause complications in an ischemic environment induced by embolization and could be a potential risk factor for uterine necrosis or perforation 7,8 . However, little research has been done comparing the results and prognosis of UFE between groups of patients with and without previous uterine surgery.…”

Section: Introductionmentioning

confidence: 99%

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Safety and effectiveness of uterine fibroid embolization in patients with scarred uterus

Jeon

Kim

et al. 2022

J of Obstet and Gynaecol

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Aim: To evaluate the safety and effectiveness of uterine fibroid embolization (UFE) in patients with a scarred uterus caused by a previous myomectomy or cesarean section. Methods: A total of 140 patients who underwent embolization for symptomatic fibroids were included in this retrospective study. The patients were divided into two groups, those with a history of myomectomy and/or cesarean section (scarred uterus group, n = 56), and those without surgical history involving the uterus (no-scar group, n = 84). Demographics, embolization details, outcomes, and complications were analyzed. Results: The overall clinical success rate was 89.28% in the scarred uterus group and 95.24% in the no-scar group. There was no statistical difference in infarction rate or change in fibroid volume in follow-up magnetic resonance imaging between the groups. There was one major complication in the no-scar group, but there was no statistical difference in complications between the groups. The mean follow-up period was 25.9 months. The mean symptom-free time was 27.2 months in the scarred uterus group and 21.9 months in the no-scar group without a significant difference. There were no statistically significant differences in symptom changes, recurrence, and complication rates between the groups. Recurrence seen on imaging or regrowth was more common in the group with myomectomy history. However, there was no significant difference in symptom recurrence rates. Conclusion: No statistically significant difference in technical and clinical outcomes was observed between the two groups. There was no significant increase in complication rates of UFE in scarred uterus group.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Safety and effectiveness of uterine fibroid embolization in patients with scarred uterus

Jeon

Kim

et al. 2022

J of Obstet and Gynaecol

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“…To the best of our knowledge, this is the first case of colouterine fistula after polymyomectomy, conservatively managed in an emergency setting. The two main etiologic hypotheses could be: (i) preoperative UAE usually associated with reduced blood supply, which could interfere with myometrial cicatrization and increase the risk of uterine fistula [ 7 - 9 ]; and (ii) the use of anti-adhesion barrier (Seprafilm®) on uterine sutures with epiploon interposition could have connected the uterine suture to the bowel leading to fistula formation. Such practice has been suspected to increase leak related events (fistula, abscess, peritonitis and sepsis) in a multicenter randomized study comparing complications of abdominal surgery with and without the use of Seprafilm® [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Colouterine fistula after polymyomectomy: a case report

et al. 2014

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IntroductionColouterine fistula is a very rare condition; most cases described in the literature are secondary to complications of diverticulitis in elderly patients.Case presentationWe report the case of a 34-year-old African woman who presented with a colouterine fistula secondary to polymyomectomy, which was diagnosed in the setting of severe endometritis. She had a Hartmann procedure and abundant irrigation of her abdominal and uterine cavities followed by placement of a double drainage in order to preserve fertility. This is the first case of a conservative management of the uterus in such conditions.ConclusionConservative surgery in colouterine fistula should be discussed as an alternative to hysterectomy in young infertile women.

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“…Uteroperitoneal fistulas are a rare cause of subfertility and pelvic pain, which tend to arise after surgery of the uterus, most frequently after cesarean section [1] or termination of pregnancy [2] but also after myomectomy [3] or salpingectomy [4]. HSG is an excellent diagnostic modality that should be performed on clinical suspicion of uterine fistulas.…”

Section: Commentmentioning

confidence: 99%