Post-operative hemorrhage after myomectomy: safety and efficacy of transcatheter uterine artery embolization.

Abstract

OBJECTIVE:

To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage.

MATERIALS AND METHODS:

We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted.

RESULTS:

The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients.

CONCLUSION:

Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

• Authors: Alvin Yu-Hon Wan, Ji Hoon Shin, Hyun-Ki Yoon, Gi-Young Ko, Sangik Park, Nak-Jong Seong, Chang-Jin Yoon
• Journal: Korean journal of radiology (Korean J Radiol) 2014 May-Jun Vol. 15 Issue 3 Pg. 356-63 ISSN: 2005-8330 [Electronic] Korea (South)
• PMID: 24843240 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Female
• Humans
• Hysterectomy
• Leiomyoma (blood supply, surgery)
• Middle Aged
• Postoperative Hemorrhage (therapy)
• Retrospective Studies
• Treatment Outcome
• Uterine Artery Embolization (adverse effects, methods)
• Uterine Neoplasms (blood supply, surgery)
• Uterus (blood supply, surgery)