In Reply to: Case 1199_02 -- Expulsion of a Large Fibroid Post Uterine Artery Embolization posted by Editor on November 02, 1999 at 10:45:43:
This happens in as many as 10% of patients. It can happen as little as a few days after UAE, and as late as several months after UAE (I had one patient call me because she sloughed a fibroid at 53 weeks).
In most cases the myoma sloughs out on its own within 24-36 hours of causing symptoms. In those who don't slough in this time frame I recommend hysteroscopy and removal of the sloughed material. I also start these patients on oral antibiotics as soon as they call me to tell me this is happening. If the sloughing fibroid isn't removed it can get infected and cause problems (and is probably the major cause of delayed infectious complications such as John Reidy has reported), so it is important to monitor the situation and get the gynecologist involved.
After the tissue is removed there is often dramatic decrease in uterine size, and corresponding improvement in symptoms. I regard this as a positive outcome of UAE.
Berkowitz RP, Hutchins FL, Worthington-Kirsch RL. Vaginal Expulsion of Submucosal Fibroids Following Uterine Artery Embolization: A Report of Three Cases. J. Reprod. Med. 1999; 44:373-376
Abhara S, Spies JB, Scialli AR, Jha RC, Lage JM, Nikolic B. Transcervical Expulsion of a Fibroid as a Result of Uterine Artery Embolization for Leiomyomata JVIR 1999; 10:409-411