Selective transarterial embolization and hysteroscopic removal of a placental polyp with preservation of reproductive capacity.
OBJECTIVE
To evaluate the role of transarterial embolization followed by hysteroscopic removal of a placental polyp with preservation of reproductive capacity.


METHODS
Three patients with placental polyps with abundant blood flow, suspected on ultrasonography with color Doppler imaging and on magnetic resonance imaging, were studied. They underwent transarterial embolization followed by hysteroscopic removal of the polyp. Transarterial embolization of the bilateral uterine arteries was carried out using an absorbable gelatin sponge. Selective removal via hysteroscopy was performed on the following day using a cutting loop without electrical stimulation. The polyp was gradually resected to the level of the surrounding endometrium.


RESULTS
Complete removal of the placental polyp was achieved in all patients. The presence of a placental polyp was confirmed by pathologic examination. The operative time was ranged from 26 to 53 minutes. In all cases, no complications were noted, and bleeding was minimal during and immediately after the procedure. Postoperative ultrasonography demonstrated a uterine cavity free of residual mass in each case.


CONCLUSIONS
Transarterial embolization of the uterine arteries followed by selective hysteroscopic removal is a safe and effective method of minimizing bleeding and preserves fertility in the treatment of placental polyps with an abundant blood flow.
Takeuchi
Kyousuke
K
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. kyousuke@skyblue.ocn.ne.jp
Ichimura
Hajime
H
Masuda
Yukiko
Y
Yamada
Takashi
T
Nakago
Satoshi
S
Maruo
Takeshi
T
D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D005298:Fertility; D006801:Humans; D015907:Hysteroscopy; D008279:Magnetic Resonance Imaging; D017063:Outcome Assessment, Health Care; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011127:Polyps / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D014599:Uterus / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*