Rapid enlargement of uterine myomas after laparoscopic bipolar coagulation of uterine vessels

Degenerative changes occur relatively frequently in uterine leiomyomas. Morphologic changes such as necrosis, hyalinization, and alterations in cellularity are described after uterine artery embolization. A modified method to interrupt the uterine blood supply is laparoscopic bipolar coagulation of uterine vessels (LBCUV). Although the success rate is good, occasional patients require hysterectomy because of complications or continuing symptoms. A woman with symptomatic myomas underwent LBCUV, but required hysterectomy due to rapid enlargement of myomas and intractable symptoms including pelvic pain and pressure, and acute urinary retention. The combination of degenerative and iatrogenic changes resulted in a histologic appearance resembling diffuse hyalinization and hydropic degeneration of the leiomyomas.