Uterine artery pseudoaneurysm should be considered as a potential cause of unexplained repetitive metrorrhagia after myomectomy, which can be successfully treated with catheter embolization.
Embolization may resolve post-myomectomy UAP bleeding; hypothesis-generating and requires confirmation in larger series.
A uterine artery pseudoaneurysm (UAP) is a rare but life-threatening complication that can occur after gynecologic surgery. Herein, we present a case of a 38-year-old woman who presented with massive uterine bleeding one month after a laparoscopically assisted myomectomy. Although the bleeding ceased spontaneously, a massive hemorrhage reoccurred three weeks thereafter, and a ruptured perfusion sac at the right uterine artery was identified by computed tomography angiography and ultrasonography. The patient was treated with transfemoral catheter embolization of the right uterine artery, and complete resolution of the UAP was successfully obtained. Our case suggests that a UAP may be a cause of unexplained repetitive metrorrhagia after myomectomy.
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Oishi et al. (2012) studied this question.
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