ABSTRACT
Uterine artery embolization (UAE) is a common minimally invasive treatment of different uterine pathologies, such as fibroids, adenomyosis, and menorrhagia. The procedure involves the injection of embolic agents into the uterine arteries, whereby various particles can be used, such as polyvinyl alcohol (PVA). Complication of UAE is the dispersion of polyvinyl alcohol (PVA) microsphere particles in the uterine body which can lead to a granular vaginal discharge. We report the management of complications of PVA microspheres dispersed from the uterine body causing postprocedural discomfort due to the vaginal passage of microspheres or because of an induced fibroid-size enlargement. The dispersion of the PVA microspheres is one example of a minor UAE complication, which nevertheless causes significant distress to the patient and eventfully requires further surgical interventions.
Subject(s)
Extravasation of Diagnostic and Therapeutic Materials , Microspheres , Polyvinyl Alcohol/therapeutic use , Uterine Artery Embolization/methods , Uterine Diseases/therapy , Adult , Female , Humans , Middle Aged , Retrospective StudiesABSTRACT
STUDY OBJECTIVE: To compare transvaginal ultrasound, hysteroscopy, and dilation and curettage (D&C) in the evaluation of women with perimenopausal and postmenopausal bleeding. DESIGN: Descriptive study (Canadian Task Force classification II-1). SETTING: Seven outpatient clinics. PATIENTS: One thousand two hundred eighty-six women. INTERVENTION: Transvaginal ultrasound, hysteroscopy, and D&C. MEASUREMENTS AND MAIN RESULTS: Of our patient population, 29 (2.26%) had a histologic diagnosis of endometrial carcinoma; in 2 of them (7.14%) endometrial thickness was 5 mm or less. In 10 women (34.5%), endometrial carcinoma was missed by hysteroscopy (sensitivity 65.52%, specificity 99.92%). Complication rate of D&C was 1.4%. CONCLUSION: In women with perimenopausal and postmenopausal bleeding neither transvaginal ultrasound nor hysteroscopy as a single diagnostic tool is suitable to rule out endometrial cancer.
Subject(s)
Dilatation and Curettage , Hysteroscopy , Uterine Diseases/diagnosis , Uterine Hemorrhage/diagnosis , Vagina/diagnostic imaging , Endometrial Neoplasms/diagnosis , Female , Humans , Middle Aged , Polyps/diagnosis , UltrasonographyABSTRACT
In a six centre prospective study complications after outpatient laparoscopies were registered. Within a four month period 1474 patients have been interviewed after one and four weeks. Surgical complications and conversions to laparotomy 0%, wound infections 2.9%, febrile course 2.4%. 3.7% of the patients were hospitalized > 24 hours. No readmissions occurred. Factors influencing the quality of results are discussed.
