Spontaneous vaginal expulsion of an infected necrotic cervical fibroid through a cervical fistula after uterine artery embolization: a case report.
BACKGROUND
Uterine artery embolization (UAE) is promising, minimally invasive therapy being offered to women for treatment of fibroids. Although it seems to be safe and effective, major complications and adverse outcomes have been reported.


METHODS
A patient treated with UAE for a huge cervical fibroid presented with an infected, necrotic cervical mass lesion 4 weeks after the procedure. Spontaneous vaginal expulsion of the infected cervical fibroid from the left lateral cervical fistula tract occurred 3 weeks later while the patient was receiving antibiotic therapy. After 6 months of intervention, an approximately 99% regression rate in the fibroid volume was achieved. The patient gave birth to a healthy, female infant following a spontaneous, uneventful pregnancy and vaginal delivery.


CONCLUSIONS
UAE appears to be associated with a significant reduction in fibroid volume. Expulsion of the infected, necrotic parts of the fibroid after UAE may be accepted as a natural process. Warning the patient about this potential risk, early recognition of infective complications and lose follow up seem to be crucial to avoiding potentially fatal septic shock.
Vural
Birol
B
Department of Obstetrics and Gynecology and of Radiology, School of Medicine, Kocaeli University, Kocaeli, Turkey.
Ozkan
Sebiha
S
Ciftçi
Ercüment
E
Bodur
Harika
H
Yücesoy
Izzet
I
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002584:Cervix Uteri / Q000473:pathology; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000628:therapy*; D009336:Necrosis / Q000188:drug therapy; D002577:Uterine Cervical Diseases / Q000209:etiology*; D014594:Uterine Neoplasms / Q000150:complications / Q000628:therapy*; D014599:Uterus / Q000098:blood supply; D019522:Vaginal Discharge
D000900:Anti-Bacterial Agents