Uterine artery embolization (UAE) is less invasive therapy for uterine fibroids; however, it can lead to infection in the uterus, ovary, and fallopian tube. We report the case of a patient who developed a pyomyoma two years after undergoing UAE, and subsequently underwent total laparoscopic hysterectomy (TLH). This report presents our findings.
A 50-year-old woman underwent UAE at a clinic two years ago; however, she discontinued her follow-up sessions due to her relocation. The patient was referred to our department due to the presence of discharge and fever of unknown origin for the past month.
During her initial visit to our department, we identified a 7.7 cm uterine fibroid with mild tenderness and an elevated inflammatory response. Based on our suspicion of a pyomyoma, we performed a TLH. Histopathological analysis revealed a leiomyoma with an infection. On postoperative day 7, the white blood cell count and C-reactive protein were elevated, and we identified a pelvic abscess at the vaginal cuff. Therefore, transvaginal abscess drainage was conducted. On day 10, the inflammatory reaction was confirmed to be negative, and the patient was discharged on day 12.
UAE can lead to complications in pyomyoma. TLH for pyomyoma presents challenges and increases the risk of postoperative infection. This condition requires bacterial culture, a combination of antibiotics, and early transvaginal drainage.
