Delayed Leiomyoma Degeneration After Microwave Endometrial Ablation

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 106; no. 5, Part 2; pp. 1176 - 1178
• Main Authors: Goldberg, Jay, McCrosson, Stacy, Kaulback, Kris R.
• Format: Journal Article
• Language: English
• Published: New York, NY The American College of Obstetricians and Gynecologists 01.11.2005; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Endometrium - pathology; Endometrium - radiation effects; Endometrium - surgery; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Leiomyoma - diagnosis; Leiomyoma - pathology; Leiomyoma - surgery; Medical sciences; Microwaves - therapeutic use; Middle Aged; Non tumoral diseases; Time Factors; Treatment Outcome; Uterine Hemorrhage - surgery; Uterine Neoplasms - diagnosis; Uterine Neoplasms - pathology; Uterine Neoplasms - surgery; Human; Leiomyoma; Gynecology; Microwave; Smooth muscle; Ablation; Obstetrics; Female genital diseases; Case study; Uterus; Degeneration; Benign neoplasm; Endometrium
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000164068.18529.eb

BACKGROUND:Microwave endometrial ablation is an effective treatment for dysfunctional uterine bleeding. Patients with leiomyomata, including submucosal leiomyomata up to 3 cm, may also be treated with microwave endometrial ablation. CASES:A 46-year-old woman with multiple leiomyomata and menometrorrhagia underwent microwave endometrial ablation. Two months after microwave endometrial ablation, she developed signs of peritoneal irritation. A negative laparoscopy excluded a thermal bowel injury. Imaging and clinical examination ultimately determined that her symptoms were due to leiomyoma degeneration. A 38-year-old woman with menometrorrhagia and leiomyomata underwent microwave endometrial ablation. Fifteen days after microwave endometrial ablation, she developed signs of peritoneal irritation. With a presumptive clinical diagnosis of microwave endometrial ablation degeneration, the patient was expectantly managed with pain medications and observation. CONCLUSION:Fibroid degeneration may have a delayed presentation after microwave endometrial ablation. Thermal bowel injury must be excluded in a patient presenting with signs of peritoneal irritation after microwave ablation of the endometrium before diagnosing leiomyoma degeneration, which can be managed expectantly.