Uterine Arteriovenous Malformation Treated with Hysteroscopic Roller Ablation

Abstract

Abstract

Background:

With the increasing rate of abortion and other intrauterine operations, uterine arteriovenous malformation (AVM) is no longer a rare entity. It can cause irregular uterine bleeding with subsequent anemia and even massive life-threatening uterine hemorrhage. Selective arterial embolization is often used as first-line treatment for this condition.

Case:

A 29-year-old women, gravida 5, para 1, had lower abdominal pain and intermittent vaginal bleeding. She had had one cesarean section and four artificial abortions. Thirteen days prior to presentation, she had undergone an artificial abortion via intrauterine aspiration. Ultrasound examination revealed an area of increased vascularity in her posterior uterine wall, which measured 18 mm × 15 mm × 7 mm. Hysteroscopy revealed a reddish spongy area in the posterior uterine wall. The patient was treated successfully with hysteroscopic roller ablation of the vascular mass, which was dehydrated and then separated from the uterine wall.

Results:

The patient recovered smoothly, and ultrasound examinations showed that there were no vascular masses in subsequent follow-ups.

Conclusions:

Hysteroscopic roller ablation could be a safe, feasible technique for treating AVM. However, further studies with longer-term follow-ups are needed to prove the technique's efficacy. (J GYNECOL SURG 33:37)