Table 1: Pseudoaneurysms of uterine artery after myomectomy reported in the literature (up to date December 2014)

Study Surgery Surgical indications Age at surgery, yrs Gravidity Signs and symptoms caused by uterine artery pseudoaneurysm Interval between surgery and symptom onset Diagnostic procedures Initial diagnosis State of pseudoaneurysm at diagnosis Size, mm Location of pseudoaneurysm Treatment procedure
Wan et al.[7] Abdominal myomectomy Menorrhagia 38 N/A hemorrage 22d CT scan N/A N/A N/A N/A Transarterial embolization
Ito et al [8] Hysteroscopic myomectomy

Hysteroscopic myomectomy 		Menorrhagia

Infertility 		39

32 		G1 P1

G0 		Massive uterine bleeding

Massive uterine bleeding 		3 d

21 d 		CT scan

CT scan 		Ruptured pseudoaneurysm

Ruptured pseudoaneurysm 		Ruptured

Ruptured

10		 Right uterine artery

Left uterine artery 		Transarterial embolization

Transarterial embolization
Higón et al [1] Abdominal myomectomy Intramural myoma 40 G1 P1 with cesarean section Sudden and abundant metrorrhagia 40 d TVUS,CDUS, pelvic arteriography Ruptured pseudoaneurysm Ruptured 30 Left uterine artery Transarterial embolization
Takeda et al [9] Laparoscopic assisted myomectomy Intramural myoma 32 G0 P0 Sudden massive uterine hemorrhage at menstruation 79 d TVUS, pelvic arteriography Massive uterine hemorrhage of unknown origin Ruptured 29 Peripheral branch of left uterine artery Transarterial embolization
Zorlu et al [10] Abdominal myomectomy Intramural myoma 27 G3 P1 Vaginal bleeding 7 d TVUS, CDUS, pelvic arteriography Unuptured pseudoaneurysm Unruptured - Left uterine artery Transarterial embolization
Oishi et al [11] Abdominal myomectomy Intramural myoma 38 G2 P2 Uterine bleeding, anemia 30 d, 51 d Pelvic Sonography ,CT, CT angiography Pseudoaneurysm Unruptured then ruptured 20 Right uterine artery Transarterial embolization
Takeda et al [12] Laparoscopic assisted myomectomy

Laparoscopic assisted myomectomy 		Intramural myoma

Intramural myoma 		32

41 		G1 P0

G0 		Fever elevated CRP

Fever,elevated CRP elevated white blood cell counts 		3 d

3 d 		Routinary post-operative TVUS, CDUS,CT

Routinary post-operative TVUS,CDUS,CT 		Pseudoaneurysm

Pseudoaneurysm 		Unruptured

Unruptured 		27

23 		Right uterine artery

Left uterine artery 		Transarterial embolization

Transarterial embolization
Asai et al [13] Laparoscopic myomectomy infertility 36 G0 Asymptomatic, Metrorrhagia 120 d, 4 d Routinary post-operative TVUS, CDUS,MRI,CT Pseudoaneurysm Unruptured then ruptured 53 Left uterine artery Transarterial embolization
Current report Laparoscopic gasless myomectomy Intramural myoma 43 G0 Abdominal pain, rectal bleeding, anemia 30 d TV US,CT Pelvic arteriography Pseudoaneurysm Ruptured - Left uterine artery Transarterial embolization


CT: Computerized Tomography; CRPL: C-reactive protein; MRI: Magnetic Resonance Imaging; TVUS: Transvaginal Ultrasound; CDUS: Color Doppler Ultrasound