Early diagnosis and endovascular management of uterine artery pseudoaneurysm after laparoscopic-assisted myomectomy

Severe Postcoital Bleeding From a Uterine Artery Pseudoaneurysm 4 Months After Cesarean Delivery

“…In general, development of pseudoaneurysms is a complication of vascular injury resulting from inflammation, trauma, or iatrogenic causes such as surgical procedures, percutaneous biopsy, or drainage. 3 In our case, the addition of extra hemostatic sutures to control the bleeding at the uterine incision angles may have resulted in the vascular injury leading to uterine artery pseudoaneurysm. The interval from pelvic surgery to the onset of symptoms is typically 1 week to 3 months, but it can manifest as late as 2 years later.…”

Novel approach to uterine artery pseudoaneurysm embolization for delayed post‐partum hemorrhage

“…Although there are no clinical trials comparing the various pharmacologic, surgical, and endovascular interventions, more definitive treatment options include surgical ligation of the internal iliac or uterine artery, arterial embolization, or even extended bimanual ultrasound probe compression therapy . Surgical ligation is complicated by the need for repeat dissection of the recent surgical bed, general anesthesia, and difficulty identifying the feeding artery given surrounding hematoma . Furthermore, it may only be effective 50% of the time (likely owing to extensive uterine collaterals), which leaves the patient with hysterectomy as the only other definitive surgical solution …”

Uterine artery pseudoaneurysms secondary to tubal surgery

“…A uterine artery pseudoaneurysm (UAP) is a rare but well‐recognized complication of cesarean delivery [1]. UAPs can also follow hysterectomy [2] and laparoscopic‐assisted myomectomy [3].…”