%0 Review %T Microwave ablation for diffuse adenomyosis leading to multiple complications after hysterectomy: A case report and literature review. %A Yang X %A Zhao W %A Chen S %A Yang J %J Medicine (Baltimore) %V 103 %N 14 %D 2024 Apr 5 %M 38579043 %F 1.817 %R 10.1097/MD.0000000000037701 %X BACKGROUND: Hysterectomy after microwave ablation (MWA) is more difficult than conventional surgery which increases the probability of postoperative complications due to MWA's collateral thermal damage to nearby intestines. Here we report a case of multiple postoperative complications after hysterectomy following MWA.
METHODS: A 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy.
METHODS: 1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation.
METHODS: The patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation.
RESULTS: After 48 days of comprehensive treatment, the patient was cured and discharged.
CONCLUSIONS: Microwave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.