Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.3052
Peer-review started: December 3, 2022
First decision: February 17, 2023
Revised: February 24, 2023
Accepted: March 31, 2023
Article in press: March 31, 2023
Published online: May 6, 2023
Vaginal myomectomy is the most common form of radical treatment for prolapsed submucosal leiomyoma and is typically performed under general anesthesia. However, an alternative treatment approach is needed for patients who cannot tolerate general anesthesia. We describe a case with such a patient who was successfully treated via a minimally invasive method under local anesthesia.
A 46-year-old female suffered from abnormal uterine bleeding, severe anemia, and a reduced quality of life attributed to a massive prolapsed submucosal leiomyoma. She could not tolerate general anesthesia due to a congenital thoracic malformation and cardiopulmonary insufficiency. A new individualized combined treatment, consisting uterine artery embolization (UAE), percutaneous microwave ablation (PMWA) of the pedicle and the endometrium, and trans
UAE combined with PMWA can be performed under local anesthesia and is a promising alternative treatment for patients who cannot tolerate general anesthesia.
Core Tip: Uterine leiomyoma is a clinically common and benign tumor. The mainstream treatment for prolapsed leiomyoma is myomectomy. General anesthesia is usually needed when resecting large lesions. However, for patients with severe systematic disease who cannot tolerate general anesthesia, radical treatment is not feasible. We report a patient who was treated successfully via a minimally invasive method under local anesthesia. A large prolapsed leiomyoma was removed after a combination of uterine artery embolism and percutaneous microwave ablation treatment. This is a good example of the use of minimally invasive interventional technology for treating special patients.