Rectal perforation: An unusual complication of uterine artery embolisation

Mallick, Rebecca; Okojie, A I O; Ajala, Tosin

doi:10.1080/01443615.2016.1180506

Cited by 8 publications

(2 citation statements)

References 5 publications

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“…Medical therapy involves long recovery times, whereas UAE has complications such as postthrombotic syndrome, injury to ovarian function and the urinary system, and even pulmonary embolism, [ 1 ] sepsis, [ 2 ] and rectal perforation. [ 3 ] Neither medical therapy nor UAE in combination with dilatation and curettage can repair scar dehiscence, and these treatments do not reduce the risk of recurrence, particularly for patients who wish to preserve fertility. An ideal treatment should eliminate the embryo, repair the uterine defect, and preserve fertility without massive bleeding.…”

Section: Introductionmentioning

confidence: 99%

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries

Xia

et al. 2018

Medicine

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Rationale:Cesarean scar pregnancy is a rare event that carries a risk of heavy hemorrhage and emergency hysterectomy. Many treatment modalities have been reported, but with no consensus. Here we report a case of combined laparoscopic and hysteroscopic treatment with temporary occlusion of the bilateral internal iliac arteries.Patient concerns:A 28-year-old woman presented with amenorrhea diagnosed as an 11-week cesarean scar pregnancy after an unsuccessful abortion. The patient's serum human chorionic gonadotropin level was 40,542 mIU/mL. Magnetic resonance imaging revealed a mass measuring 5 × 4.5 cm over the anterior uterine isthmus.Diagnose:Type III cesarean pregnancy.Interventions:Diagnostic and operative laparoscopy were performed to remove the pregnancy tissue and repair the scar dehiscence after temporary occlusion of the bilateral internal iliac arteries, followed by hysteroscopy to confirm no pregnancy remnants and to free intrauterine adhesions.Outcomes:Intraoperative and postoperative bleeding were minimal. The postoperative recovery was uneventful. Human chorionic gonadotropin normalized after 3 weeks.Lessons:Temporary occlusion of the bilateral internal iliac arteries seems to be a good strategy to reduce hemorrhage in cesarean scar pregnancy. Hysteroscopy is necessary to deal with intrauterine lesions.

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Section: Introductionmentioning

confidence: 99%

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries

Xia

et al. 2018

Medicine

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“…UAE combined with MTX has been reported as an effective treatment for exogenous CSP [19]. However, complications from UAE, such as long-term premature ovarian failure, post thrombotic syndrome, pulmonary embolism, and septic rectal perforation, occur [20][21][22][23]. Recently, HIFU has been reported to achieve satisfactory results in the treatment of broids and adenomyosis [24,25].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the treatment of high intensity focused ultrasound combined with suction curettage for exogenous cesarean scar pregnancy

Weng

Wang

2022

Arch Gynecol Obstet

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Purpose: To evaluate the effectiveness of high intensity focused ultrasound (HIFU) combined with suction curettage in the treatment of exogenous cesarean scar pregnancy (CSP).Methods: A total of 41 patients diagnosed with exogenous CSP were enrolled in this study. All patients received HIFU treatment combined with suction curettage.Results: Twenty-nine patients were administered one session of HIFU ablation. In addition, the other 12 patients received 2 HIFU sessions. Suction curettage was performed in all patients after HIFU, and no patient was converted to laparoscopy or hysterectomy. The mean blood loss during suction curettage was 99 ml. Three patients received two sessions of suction curettage. The success rate of our study was 92.68%. The mean time for serum β-HCG normalization was 23.18±3.13 days. The average menstruation recovery time was 29.38±3.34 days. Based on the blood loss during suction curettage, 41 patients were divided into a bleeding group and a control group. The size of the gestational sac in the bleeding group (3.80±0.87 cm) was larger than that in the control group (3.39±0.77 cm) (P <0.05). The thickness of the myometrium between the bladder and gestational sac in the bleeding group (2.37±0.89 mm) was less than that in the control group (2.75±0.75 mm) (P <0.05). Conclusion:The results suggested that HIFU combined with suction curettage could be considered an effective treatment for exogenous CSP of < 9 weeks. The size of the gestational sac and the thickness of the myometrium between the bladder and gestational sac might be high-risk factors for blood loss during this treatment.

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Care Delivery for Patients with Leiomyomas: Failures, Real-Life Experiences, Analysis of Barriers, and Proposed Restorative Remedies

Lerner,

Donnellan,

Siedhoff

et al. 2023

Health Equity

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In this narrative review, we describe historical and contemporary influences that prevent patients with fibroids from getting appropriate medical care. Using patient stories as examples, we highlight how misogyny on all levels hurts patients and prevents medical teams from doing their best. Importantly, inequity and disparities result in massive gaps in care delivery. We suggest that we, as gynecologists and surgeons, must join public discourse on this topic to highlight the inadequacies of care delivery and the reasons behind it, suggest potential solutions, and join patients and communities in formulating and implementing remedies.

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Rectal perforation: An unusual complication of uterine artery embolisation

Cited by 8 publications

References 5 publications

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries

Evaluation of the treatment of high intensity focused ultrasound combined with suction curettage for exogenous cesarean scar pregnancy

Care Delivery for Patients with Leiomyomas: Failures, Real-Life Experiences, Analysis of Barriers, and Proposed Restorative Remedies

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