Organ-preserving approach to the treatment of patients with uterine fibroids and congenital anomaly of the urinary system (a clinical case)

Abstract

Congenital anomalies of the urogenital system constitute approximately 20 to 30% of all birth defects. Renal dystopia means a congenital abnormal location of one or both kidneys. The authors present a clinical case report, demonstrating the efficacy of uterine artery embolization as an alternative method of treatment for patients with uterine fibroids and renal dystopia. Uterine artery embolization is not only an organ- preserving treatment option for women who wish to retain the reproductive organ but also offers a clear visualization of the individual anatomical variations. Taking into consideration a strong patient’s wish to preserve the uterus and her individual vascular anomalies (absence of the left uterine and renal arteries), uterine artery embolization was an alternative treatment option which enabled to preserve both the uterus and the left kidney. The scheduled examination findings demonstrated a 1.87-fold reduction of the uterine volume and a 12.8-fold reduction of the fibroid size from baseline, and color doppler ultrasonography revealed that the uterine fibroid was avascular. For patients with diagnosed congenital anomalies of the urogenital system, the authors recommend using computer tomography and referrals to interdisciplinary specialists for choosing the appropriate uterine fibroid treatment options KEYWORDS: uterine fibroids, pelvic kidney dystopia, uterine artery embolization, organ-preserving treatment methods, congenital anomalies of the urogenital system, computer tomography. FOR CITATION: Antropova E.Yu., Sharafutdinov B.M., Mazitova M.I. et al. Organ-preserving approach to the treatment of patients with uterine fibroids and congenital anomaly of the urinary system (a clinical case). Russian Journal of Woman and Child Health. 2022;5(4):320–325 (in Russ.). DOI: 10.32364/2618-8430-2022-5-4-320-325.