Successful treatment of uterine artery pseudoaneurysm with laparoscopic temporary clamping of bilateral uterine arteries, followed by hysteroscopic surgery

Hajime Ota, Yoshiyuki Fukushi, Shinichiro Wada, Takafumi Fujino, Yuko Omori, Miki Kushima

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Surgical strategies for the treatment of uterine artery pseudoaneurysm (UAP) include transarterial embolization and ultrasound-guided low-dose thrombin injection. Such strategies, however, have limitations and include the risk of ischemic damage to the uterus. We report a case of UAP treated with a new hysteroscopic and laparoscopic technique. A 29-year-old G1P0 woman with spontaneous abortion was transferred to the present institution because of hemorrhagic shock. We diagnosed ruptured UAP on transvaginal ultrasound with color Doppler. Emergency laparoscopic temporary clamping of the bilateral uterine arteries was done to reduce the bleeding, and transcervical resection to stop the hemorrhaging and to collect the pseudoaneurysm tissue. After surgery, blood flow to the myometrium was monitored on ultrasound. By postoperative day 48, normal menstruation had restarted, and no intrauterine adhesions were observed. On pathology of the UAP, a dilated spiral artery without its characteristic elastic fibers was identified. This surgical approach may help preserve fertility and allow for pathological diagnosis of UAP.

Original languageEnglish
Pages (from-to)1356-1359
Number of pages4
JournalJournal of Obstetrics and Gynaecology Research
Volume43
Issue number8
DOIs
Publication statusPublished - 2017 Aug
Externally publishedYes

Keywords

  • hysteroscopic surgery
  • laparoscopic surgery
  • uterine artery pseudoaneurysm

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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