A case of placental polyp successfully treated by hysteroscopic transcervical resection with temporary endovascular balloon occlusion of both internal iliac arteries.

Abstract

  A 24-year-old woman was referred to us because of persistent vaginal bleeding after curettage for a delayed miscarriage. Transvaginal color Doppler ultrasonography and MRI revealed a mass measuring 3 × 2 cm with abundant blood flow in the uterine cavity. Her hCG was 4.7 mIU/ml. We diagnosed retained placenta or placental polyp on the basis of the characteristic clinical findings. Hysteroscopic transcervical resection (TCR) was performed with perioperative endovascular placement of occlusion balloon in both internal iliac arteries. Endoscopy revealed a 3-cm broad-based yellow polypoid tumor on the posterior wall of the uterine corpus. The procedure lasted 23 minutes, and the inflation time of balloon catheters was 13 minutes. The estimated blood loss was small. There were no technique-related problems or complications. The sheath catheter was removed immediately after the operation. The pathological diagnosis was placental polyp. TCR with internal iliac artery balloon occlusion appears to be a good procedure for treating placental polyp.