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Human Reproduction, Vol. 18, No. 1, 167-171, January 2003
© 2003 European Society of Human Reproduction and Embryology

Case Reports

Incomplete vaginal expulsion of pyoadenomyoma with sepsis and focal bladder necrosis after uterine artery embolization for symptomatic adenomyosis: Case report

Li-Ying Huang1, Yu-Fan Cheng2, Chao-Cheng Huang3, Shiuh-Young Chang1 and Fu-Tsai Kung1,4

1 Department of Obstetrics and Gynecology, 2 Department of Radiology and 3 Department of Pathology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan 4 To whom correspondence should be addressed at Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan. e-mail: ftkung{at}ksts.seed.net.tw

The major complications secondary to uterine artery embolization (UAE) are rare. We report a case involving a patient who underwent UAE for symptomatic adenomyosis, and experienced complications including incomplete vaginal expulsion of a large focal pyoadenomyosis, sepsis and focal bladder necrosis. The serial changes of uterine echogenicity reflected the intracavity sloughing tissue, and cystourethroscopy revealed a focal bladder necrosis. Administration of appropriate antibiotics and timely expulsion of the focal pyoadenomyosis vaginally resulted in successful preservation of the uterus and spontaneous recovery of focal bladder necrosis without surgical intervention. A review of the relevant literature was conducted to explore the mechanisms of bladder necrosis after UAE, summarize post-embolization intervention and the outcome of vaginally expelled myoma, and to discuss the value of UAE for adenomyosis.

Key words: adenomyosis/bladder necrosis/embolization/sepsis/uterine myoma


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