Fibroid Expulsion after Uterine Artery Embolization

Area of Science:

• Interventional Radiology
• Gynecologic Surgery
• Vascular Imaging

Background:

• Uterine artery embolization (UAE) is a common treatment for symptomatic leiomyomata, prioritizing uterine preservation.
• While generally safe, UAE carries risks including postembolization syndrome, amenorrhea, and vaginal discharge.
• Fibroid expulsion (FE) is a less common but significant complication of UAE.

Purpose of the Study:

• To describe a case of fibroid expulsion following uterine artery embolization.
• To review the literature on fibroid expulsion after UAE.
• To provide recommendations for managing this complication.

Main Methods:

• Case report of a patient experiencing fibroid expulsion post-UAE.
• Comprehensive literature review on fibroid expulsion rates, risk factors, and management strategies.
• Analysis of clinical outcomes and treatment approaches for fibroid expulsion.

Main Results:

• Fibroid expulsion rates post-UAE range from 3% to 50%, typically cited between 5% and 15%.
• Pedunculated submucosal, submucosal, and transmural fibroids are identified as high-risk for expulsion.
• Nonoperative management is frequently employed for fibroid expulsion, though optimal strategies are debated.

Conclusions:

• Fibroid expulsion is an uncommon complication of UAE that requires careful consideration.
• Patient selection and awareness of high-risk fibroid types can help anticipate potential FE.
• Further research is needed to establish definitive management guidelines for fibroid expulsion post-UAE.