Author/Authors :
Ouyang, Jing Shanghai Municipal Key Clinical Speciality, Shanghai, China , Wei, Xia Shanghai Municipal Key Clinical Speciality, Shanghai, China , Yang, Siqin Shanghai Municipal Key Clinical Speciality, Shanghai, China , Shi, Yiru Shanghai Municipal Key Clinical Speciality, Shanghai, China , Hu, Shiqing Shanghai Municipal Key Clinical Speciality, Shanghai, China , Zhang, Jian Shanghai Municipal Key Clinical Speciality, Shanghai, China
Abstract :
Objectives: The current study presented a fertility-preserving laparoscopic approach combined with hysteroscopy for the treatment of a uterine arteriovenous malformation (AVM) after a failed uterine artery embolization (UAE).
Case Presentation: The patient was diagnosed with acquired uterine AVM and underwent a UAE, followed with the recurrence of massive vaginal bleeding. The computed tomography angiography (CTA) demonstrated AVM neovascularization and the patient profoundly desired to preserve her fertility.
Results: The patient underwent a laparoscopic surgery combined with hysteroscopy during which the supply vessels of the AVM were obliterated and a 3-month GnRHa regimen was prescribed accordingly. The follow-up CTA was performed at postoperative day 3 and month 5. Both of the obtained images indicated the remission of the AVM. Thus, the patient remained asymptomatic during a 18-month follow-up after the operation.
Conclusions: In general, the laparoscopic obliteration of the supply vessels of the uterine AVM could provide an alternative to hysterectomy in patients whose embolization attempt failed and thus had a fertility-preserving desire.
Keywords :
Uterine arteries embolization , Hysteroscopy , Uterine arteriovenous malformation , Laparoscopy
