Myometrium defects occurred after conservative treatment of uterine fibroid. A report of 4 cases.
Marat Tugushev (RU), Alexandr Klimanov (RU), Oxana Pomazanova (RU), Olga Ermolaeva (RU)
[Tugushev] Samara State medical University, Medical company IDK - Mat' i Ditya, Samara., [Klimanov] Samara State medical University, Medical company IDK - Mat' i Ditya, Samara., [Pomazanova] Samara State medical University, Medical company IDK - Mat' i Ditya, Samara., [Ermolaeva] Samara State medical University, Medical company IDK - Mat' i Ditya, Samara.
Objective. Uterine fibroids are benign tumor of the smooth muscles that can negatively affect fertility and associate with higher risk of pregnancy complications. Methods. MR-guided Focused Ultrasound (MRgFU) and Uterine Artery Embolization (UAE) are a non-invasive way to treat uterine fibroids. But they are not recommended for women who plan to become pregnant. Patient(s). Four women came to our private clinic with long-term complications after MRgFUand UAE that were done from 2012 to 2014. Women had complaints of excessive menstrual bleeding and infertility before these procedures. There were subserosal-intramural fibroids in three cases: the 1st- woman 46 y.o., the 3rd - woman 33 y.o. and the 4th - woman 34 y.o. They had myomas to 116 mm,37 and 44 mm and to 68 mmin diameter, respectively. Fibroid deformed of uterine cavity in the 1st case. There was submucosal-intramural fibroid in case2 (woman 39 y.o.) to 60 mm in diameter. Intervention(s). A MRgFU was done in the 2nd and the 3rd cases. Women from the 1st and the 4th cases underwent an UAE. Women came to our clinic after these procedures. The Bettocchi office hysteroscopy (OH) was used for control treatment results at 2015. Main Outcome Measures. Condition of UC by OH. Results.Conclusion of OH are following: defects like a “crater shape” from 5 to 15 mm in length were visualized in UC. In the 3rd and the 4th cases defect communicated with cavity of necrotic changed fibroid, in case 3 – also with calcifications in the myoma. In case2 the residual fibroid 10 mm in diameter was visualized and was removed by operative hysteroscopy. Conclusion. Currently there is not enough information about woman fertility and pregnancy complications after UAE and MRgFU. That is why both of these methods cannot be recommended for woman, who wants to become pregnant.