Abstract
Uterine artery embolization (UAE) is a ubiquitous procedure, and a broadly recognized
alternative to surgical interventions for symptomatic leiomyomata when uterine preservation
is desired. Aside from postembolization syndrome (typically considered an expected
feature of recovery), the most frequently described complications are temporary or
permanent amenorrhea and lingering vaginal discharge. Less frequently described complications
include fibroid expulsion (FE), protracted or refractory pain, infection, urinary
retention, and access-related injuries. Reported rates of transcervical FE vary in
the literature from 3 to 50% but are most often quoted to be around 5 to 15%. Certain
features predispose a patient to FE, including size and location of the tumor, with
pedunculated submucosal, submucosal, and transmural lesions considered to be “high
risk.” While the optimal management of FE has not been definitively determined, high
rates of nonoperative management of FE are noted in the literature. This article describes
a case in which a fibroid was expulsed following UAE, as well as the management of
the complication. A literature review and recommendations for the management of FE
is also given.
Keywords
fibroid expulsion - uterine artery embolization - deep vein thrombosis - iliac vein
stent - interventional radiology
