International Journal of Women's Health and Reproduction Sciences

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Oct 2019, Vol 7, Issue 4

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Case Report
A Fertility-Preserving Laparoscopic Management Combined With Hysteroscopy of Uterine Arteriovenous Malformation Followed by Uterine Arteries Embolization: A Case Report
Jing Ouyang^1,2,3, Xia Wei^1,2,3, Siqin Yang^1,2,3, Yiru Shi^1,2,3, Shiqing Hu^1,2,3, Jian Zhang^1,2,3*
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 DOI: 10.15296/ijwhr.2019.88 Viewed : 2532 times Downloaded : 2070 times. Keywords : Uterine arteriovenous malformation, Laparoscopy, Hysteroscopy, Uterine arteries embolization
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Abstract

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.