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. 2022 Feb 15:2022:7426210.
doi: 10.1155/2022/7426210. eCollection 2022.

Extravascular Dispersion of Polyvinyl Alcohol Microsphere Particles in Uterine Artery Embolization

L A Torres-de la Roche  1 , C Cezar  1 , S Hanif  2 , R Devassy  1   2 , H Krentel  3 , J Hennefründ  1 , R L De Wilde  1
Affiliations

Extravascular Dispersion of Polyvinyl Alcohol Microsphere Particles in Uterine Artery Embolization

L A Torres-de la Roche et al. Biomed Res Int. .

Abstract

Uterine artery embolization (UAE) is a common minimally invasive treatment of different uterine pathologies, such as fibroids, adenomyosis, and menorrhagia. The procedure involves the injection of embolic agents into the uterine arteries, whereby various particles can be used, such as polyvinyl alcohol (PVA). Complication of UAE is the dispersion of polyvinyl alcohol (PVA) microsphere particles in the uterine body which can lead to a granular vaginal discharge. We report the management of complications of PVA microspheres dispersed from the uterine body causing postprocedural discomfort due to the vaginal passage of microspheres or because of an induced fibroid-size enlargement. The dispersion of the PVA microspheres is one example of a minor UAE complication, which nevertheless causes significant distress to the patient and eventfully requires further surgical interventions.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Extrusion of PVA microspheres as observed at laparoscopic supracervical hysterectomy.
Figure 2
Figure 2
Laparoscopic supracervical hysterectomy in case 1, multiple small myomas visible during operation.
Figure 3
Figure 3
Myomectomy, intraoperative visualization of PVA microspheres.
Figure 4
Figure 4
Successful myomectomy.
Figure 5
Figure 5
Morcellation of myomas.
Figure 6
Figure 6
Hysteroscopic aspect of residual myomas and PVA granules. (a) Residual myomas. (b) Polyvinyl alcohol granules.
Figure 7
Figure 7
Hysteroscopic resection of the sub-mucous fibroids.
Figure 8
Figure 8
Hysteroscopic resection of endometrium.
See this image and copyright information in PMC

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