Myoma expulsion after embolization: case report and literature review

Uterine artery embolization (UAE) is a very efficient treatment modality for myoma. A rare complication of this procedure is vaginal expulsion of the uterine myoma (expelled myoma) which may occur in 3 to 5% of cases during a period of 3 to 48 months. We report a case of myoma expulsion after embolization, discussing diagnosis and treatment. A literature review was also conducted. A 40-year-old patient sought medical care on 5/2/2021 with intermittent pelvic pain and hypermenorrhagia. Vaginal ultrasound revealed an enlarged uterus (253 cm(3)) with myomas. The largest intramural myoma measured 7 cm. Uterine artery embolization was performed on 11/11/2021, without any complications. On 12/7/2021, during clinical examination an expelled myoma was observed entirely inside the vaginal canal. A vaginal myomectomy was performed, without any complications. At 15 months after the initial follow-up, the patient is doing well.