Delayed leiomyoma degeneration after microwave endometrial ablation.
BACKGROUND
Microwave endometrial ablation is an effective treatment for dysfunctional uterine bleeding. Patients with leiomyomata, including submucosal leiomyomata up to 3 cm, may also be treated with microwave endometrial ablation.


METHODS
A 46-year-old woman with multiple leiomyomata and menometrorrhagia underwent microwave endometrial ablation. Two months after microwave endometrial ablation, she developed signs of peritoneal irritation. A negative laparoscopy excluded a thermal bowel injury. Imaging and clinical examination ultimately determined that her symptoms were due to leiomyoma degeneration. A 38-year-old woman with menometrorrhagia and leiomyomata underwent microwave endometrial ablation. Fifteen days after microwave endometrial ablation, she developed signs of peritoneal irritation. With a presumptive clinical diagnosis of microwave endometrial ablation degeneration, the patient was expectantly managed with pain medications and observation.


CONCLUSIONS
Fibroid degeneration may have a delayed presentation after microwave endometrial ablation. Thermal bowel injury must be excluded in a patient presenting with signs of peritoneal irritation after microwave ablation of the endometrium before diagnosing leiomyoma degeneration, which can be managed expectantly.
Goldberg
Jay
J
Department of Obstetrics, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. jay.goldberg@jefferson.edu
McCrosson
Stacy
S
Kaulback
Kris R
KR
D000328:Adult; D004717:Endometrium / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000601:surgery*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*