|A Fertility-Preserving Laparoscopic Management Combined With Hysteroscopy of Uterine Arteriovenous Malformation Followed by Uterine Arteries Embolization: A Case Report|
|Jing Ouyang1,2,3, Xia Wei1,2,3, Siqin Yang1,2,3, Yiru Shi1,2,3, Shiqing Hu1,2,3, Jian Zhang1,2,3*|
|1Department of Obstetrics and Gynecology, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
2Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
3Shanghai Municipal Key Clinical Speciality, Shanghai, China
IJWHR 2019; 7: 531-534
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Keywords : Uterine arteriovenous malformation, Laparoscopy, Hysteroscopy, Uterine arteries embolization
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Objectives: The current study presented a fertility-preserving laparoscopic approach combined with hysteroscopy for the treatment of a uterine arteriovenous malformation (AVM) after a failed uterine artery embolization (UAE).
Case Presentation: The patient was diagnosed with acquired uterine AVM and underwent a UAE, followed with the recurrence of massive vaginal bleeding. The computed tomography angiography (CTA) demonstrated AVM neovascularization and the patient profoundly desired to preserve her fertility.
Results: The patient underwent a laparoscopic surgery combined with hysteroscopy during which the supply vessels of the AVM were obliterated and a 3-month GnRHa regimen was prescribed accordingly. The follow-up CTA was performed at postoperative day 3 and month 5. Both of the obtained images indicated the remission of the AVM. Thus, the patient remained asymptomatic during a 18-month follow-up after the operation.
Conclusions: In general, the laparoscopic obliteration of the supply vessels of the uterine AVM could provide an alternative to hysterectomy in patients whose embolization attempt failed and thus had a fertility-preserving desire.
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