Challenges in the Management of Postmenopausal Uterine Artery Venous Malformation
Pooja Sahu, Deepthy Balakrishnan, Ranjan K. Patel, Tara Prasad TripathyABSTRACT
Uterine arteriovenous malformation (UAVM) is an infrequent occurrence among postmenopausal women. Our review of the literature revealed only a few documented cases of UAVM in this demographic. Treatment options for these patients encompass uterine artery embolization (UAE), medical management, and hysterectomy. We encountered a case involving a 54-year-old woman, postmenopausal for 9 years, who presented with a history of postmenopausal bleeding over the preceding 3 months. Imaging studies confirmed the presence of UAVM. Despite an attempted UAE, the procedure proved unsuccessful, leading to the decision to perform a hysterectomy with meticulous attention to minimizing blood loss. Notably, UAE may not consistently achieve favorable outcomes in addressing UAVM in postmenopausal women, thereby underscoring the consideration of hysterectomy as a safe alternative – treatment option without any excessive intraoperative bleeding.