Myoma expulsion after embolization: case report and literature review

Area of Science:

• Gynecology
• Interventional Radiology

Background:

• Uterine artery embolization (UAE) is a primary treatment for uterine fibroids, offering high efficacy.
• Vaginal expulsion of uterine myoma is a rare but documented complication following UAE, occurring in 3-5% of cases within 3-48 months post-procedure.

Approach:

• This report details a case of vaginal myoma expulsion after UAE.
• The case involved a 40-year-old patient presenting with pelvic pain and hypermenorrhagia, diagnosed with uterine fibroids via ultrasound.
• Diagnostic imaging confirmed an enlarged uterus (253 cm³), with the largest intramural myoma measuring 7 cm.

Key Points:

• UAE was performed on November 11, 2021, with no immediate complications.
• On December 7, 2021, a vaginal myomectomy was successfully performed to remove the expelled myoma.
• The patient experienced a favorable outcome, with no complications reported at the 15-month follow-up.

Conclusions:

• Vaginal myomectomy is an effective treatment for expelled myomas post-UAE.
• This case highlights the importance of recognizing and managing this rare complication.