Ali Cenk ÖZAY, Özlen EMEKÇİ, Berrin ACAR, Aygün AKBEROVA, Aslı AKDÖNER

Uterin Arter Embolizasyonu Sonrası Myoma Uterinin Ekspulsiyonu: Olgu sunumu

Giriş: Uterin arter embolizasyonundan sonra myomların servikal prolapsusu nadir görülen durumlardan biridir. Kavite içerisindeki saplı, büyük çaplı, küçüldüğünde prolabe olabilecek myomlarda dikkatli olunması gereklidir. Olgu: Anormal vajinal kanama ile başvuran 42 yaşındaki hastanın yapılan jinekolojik değerlendirmesinde 10x11 cm myom saptandı. Cerrahi tedaviyi kabul etmeyen hastaya uterin arter embolizasyonu uygulandı. İşlemden 8 gün sonra myom prolapsusu ve yoğun vajinal kanama ile acil servise başvuran hastaya total abdominal histerektomi yapıldı. Sonuç: Büyük çaplı myomlar uterin arter embolizasyonundan her zaman fayda görmemektedir

Expulsion of A Uterin Myoma After Uterin Artery Embolization: Case Report

Introduction: Cervical prolapse of fibroids is one of the rare condition after uterine artery embolization. Case Report: A 42 years old woman was admitted with abnormal vaginal bleeding. In her vaginal examination 6 cm myoma was detected. She refused operation and therefore uterine artery was embolization was done. 8 days after the embolization she was admitted to emergency unit with prolapse of the myoma and vaginal bleeding and she had total abdominal hysterectomy. Conclusion: Large myomas won’t always benefit from uterin artery embolization.

PDF

___

Goodwin SC, McLucas B, Vdantham S, Perrella S. Pre- liminary experience with uterine artery embolization for uterine fibroids. J Vasc Interve Radiol. 1997 ;8:517-526.
Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bou- ret JM, Houdart E, Aymard A, Merland JJ. Arterial em- bolisation to treat uterine myomata. Lancet. 1995 Sep 9;346(8976):671-2.
Marret H, Keris Yle B, Acker O, Cottier JP, Herbreteau D. Late leiomyoma expulsion after uterine artery emboli- zation. J Vasc Interv Radiol 2004; 15:1483-1485.
Hehenkamp WJ, Volkers NA, Montauban Van Swijnd- regt AD, Blok SD, Reekers JA, Ankum WM. Myoma ex- pulsion after uterine artery embolization: complication or cure? Am J Obstet Gynecol. 2004; 191:1713-1715.
Goodwin SC, McLucas B, Lee M. Uterine artery em- bolisation for treatment of uterine leiomyomata midterm results. J Vasc Interv Radiol. 1999;10:1159-65.
Siskin GP, Stainken BF, Dowling K. Outpatient uterine arteryembolisation for symptomatic uterine fibroids: expe- rience in 49patients. J Vasc Inerv Radiol. 2000;11:305-11. 7. Olive DL. New approches to management of fibroids. Obstet Gynecol Clin North Am. 2000;27:669-77.
McLucas B, Adler L, Perrella R. Uterine fibroid embo- lization: nonsurgical treatment for symptomatic fibroids. J Am Coll Surg. 2001a;192:95-105.
Goodwin SC, Spies JB, Worthington-Kirsch R, Peterson E, Pron G, Li S, Myers E. Uterine artery embolization for treatment of leiomyomata. Long-term outcomes from the FIBROID Registry. Obstet Gynecol. 2008;111:22-33.
Laverge F, D'Angelo A, Davies NJ, Wood A, Amso NN. Spontaneous expulsion of three large fibroids after uterine artery embolization. Fertil Steril 2003; 80:450-452.
Abbara S, Spies JB, Scialli AR, Jha RC, Lage JM, Ni- kolic B. Transcervical expulsion of a fibroid as a result of uterine artery embolization for leiomyomata, J Vasc Interv Radiol. 1999 Apr;10(4):409-11.
Shlansky-Goldberg RD, Coryell L, Stavropoulos SW, Trerotola SO et all. Outcomes Following Fibroid Expulsi- on after Uterine Artery Embolization. J Vasc Interv Radi- ol. 2011; 22:1586-1593.