Fibroid-induced acute urinary retention: treatment by uterine artery embolization.
A 39-year-old gravida 2 para 2 woman presented to our Hospital's Emergency Department with complaints of difficulty voiding. She had an enlarged leiomyomatous uterus, for which she was not receiving any current treatment. A Foley catheter placed yielded 1,500 cc of clear yellow urine; however, the patient remained Foley-dependent for 2 weeks until she underwent uterine artery embolization (UAE). Twenty-four hours afterwards, the Foley catheter was removed and the patient spontaneously voided with negligible post-void residual. There was no recurrence of urinary retention or development of any other urinary symptoms during the outpatient follow-up period. Repeat pelvic magnetic resonance imaging (MRI) 1 week after UAE showed negligible reduction in the size of the fibroids and uterus in comparison with a pre-procedure MRI. The Vascular Steal Theory, first presented in this paper, discusses this improvement in symptoms without significant change in size.
Arleo
Elizabeth Kagan
EK
Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY, USA. ekarleo@hotmail.com
Tal
Michael G
MG
D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D018231:Leiomyomatosis / Q000150:complications* / Q000628:therapy; D016055:Urinary Retention / Q000209:etiology*; D014599:Uterus / Q000098:blood supply*