Kontomanolis Emmanuel, Stylianou Chrysovalantis, Mitropoulou Styliani, Balomenos Vasileios, Souftas Vasileios
Obstetrics and Gynecology, University Hospital of Alexandroupolis, Alexandroupolis, GRC.
Radiology and Interventional Radiology, University Hospital of Alexandroupolis, Alexandroupolis, GRC.
Cureus. 2021 Dec 6;13(12):e20210. doi: 10.7759/cureus.20210. eCollection 2021 Dec.
The purpose of this case report is to present the case of a 49-year-old female individual with uterine fibroids, who underwent a subtotal hysterectomy after prior unsuccessful uterine artery embolization. Uterine artery embolization is a minimally-invasive technique used as an additional option for the treatment of symptomatic fibroids. The method is a promising technique, indicated for female individuals of reproductive age wishing to preserve their uteri.
The patient presented symptoms of bloating and menorrhagia. Magnetic Resonance Imaging revealed uterine enlargement and elongation, with several fibroids and urinary bladder deformation caused by the enlarged uterus and the numerous fibroids compressing the uterine apex. She was referred for uterine artery embolization. In the three-year follow-up imaging, no alteration of the uterus' size was observed, while two fibroids were noted, suggesting necrosis or malignancy based on imaging findings, which led to the conduction of partial hysterectomy while leaving the cervix intact.
Uterine artery embolization is regarded as a safe and successful procedure. However, in case of ineffectiveness, full or partial hysterectomy is considered as the ultimate treatment of choice.
According to the available literature, uterine artery embolization is promoted to be an efficient alternative option to surgery. Patients should be offered adequate medical consultation on all the treatment options and possible complications.
本病例报告的目的是介绍一名49岁患有子宫肌瘤的女性患者的情况，该患者在先前子宫动脉栓塞术失败后接受了次全子宫切除术。子宫动脉栓塞术是一种微创技术，用作治疗有症状子宫肌瘤的另一种选择。该方法是一种有前景的技术，适用于希望保留子宫的育龄女性。
患者出现腹胀和月经过多的症状。磁共振成像显示子宫增大和伸长，有多个肌瘤，且因子宫增大和众多肌瘤压迫子宫顶端导致膀胱变形。她被转诊接受子宫动脉栓塞术。在三年的随访成像中，未观察到子宫大小有变化，但发现有两个肌瘤，根据成像结果提示有坏死或恶性病变，这导致在保留宫颈完整的情况下进行了部分子宫切除术。
子宫动脉栓塞术被认为是一种安全且成功的手术。然而，如果无效，全子宫切除术或部分子宫切除术被视为最终的治疗选择。
根据现有文献，子宫动脉栓塞术被推广为一种有效的手术替代方案。应就所有治疗选择和可能的并发症为患者提供充分的医疗咨询。
