Complex Gynecologic Fistulas Presenting 10 Years After Uterine Artery Embolization.

Abstract

Uterine artery embolization (UAE) is a minimally invasive procedure for treatment of symptomatic uterine leiomyomas, but long-term complications are under-reported. This is the case of a healthy 51-year-old woman who had previously undergone UAE for symptomatic uterine leiomyomas. The patient presented with gross hematuria and pelvic pain 10 years later. She was found to have both a vesicouterine and a uteroduodenal fistula. The patient was successfully treated with hysterectomy, excision of the vesicouterine fistula, partial cystectomy, excision of the duodenal fistula, and primary duodenal repair. Complex gynecologic fistulas may occur as a long-term complication in symptomatic women with a history of UAE.