Objective: To describe a case in which hysteroscopic removal of a fibroid that had migrated through the uterine wall induced formation of a uterine fistula. Design: After embolization of uterine fibroids, an investigative clinical, sonographic, and hysteroscopic protocol was followed. Setting: Gynecologic clinic of a university hospital.Patient(s): A 38-year-old woman undergoing embolization of uterine arteries for uterine fibroids. Intervention(s): Angiography-guided transcatheter bilateral embolization of uterine arteries, with clinical, sonographic, and hysteroscopic follow-up. Main Outcome Measure(s): Patient morbidity and satisfactory intercourse. Result(s): Six months after embolization of the uterine arteries, the patient presented migration of the fibroid through the uterine wall. Hysteroscopic removal of the fibroid induced posthysteroscopic formation of a uterine fistula. Conclusion(s): After embolization of the uterine arteries, thorough follow-up examination of the uterine cavity is strictly recommended. Diagnosis of a uterine wall perforation can identify an abnormal source of uterine bleeding, and patients should be counseled to avoid pregnancy until the lesion heals completely.
Uterine fistula induced by hysteroscopic resection of an embolized migrated fibroid: a rare complication after embolization of uterine fibroids / De Iaco, P; Golfieri, R; Ghi, T; Muzzupapa, G; Ceccarini, M; Bovicelli, L. - In: FERTILITY AND STERILITY. - ISSN 0015-0282. - 75:4(2001), p. 818-20.