Vaginal Pessary for Uterine Repositioning during High-Intensity Focused Ultrasound Ablation of Uterine Leiomyomas

Tajana Klepac Pulanic, Aradhana M. Venkatesan, James Segars, Sham Sokka, Bradford J. Wood, Pamela Stratton

Research output: Contribution to journalReview article

Abstract

In order to ensure safe magnetic resonance-guided, high-intensity focused, ultrasound ablation of uterine leiomyomas, the ultrasound beam path should be free of intervening scar and bowel. Pre-treatment MRI of a 9-cm long and 7.7-cm wide leiomyomatous uterus in a 39-year-old woman with menorrhagia and abdominopelvic pain initially demonstrated a focused ultrasound treatment path without a bowel between the uterus and the abdominal wall. On the day of ablation, however, multiple loops of bowel were observed in the ultrasound beam path by MRI. Uterine repositioning was accomplished with a 76-mm donut vaginal pessary, which anteverted the fundus and successfully displaced the bowel. A vaginal pessary may aid in repositioning an axial or retroverted uterus to enable ablation of uterine leiomyomas.

Original languageEnglish (US)
Pages (from-to)285-288
Number of pages4
JournalGynecologic and Obstetric Investigation
Volume81
Issue number3
DOIs
StatePublished - May 1 2016
Externally publishedYes

Keywords

  • Focused ultrasound
  • Leiomyoma
  • Magnetic resonance imaging
  • Vaginal pessary

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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