Abstracto

Bilateral agenesis of the uterine arteries.

Elena Wagner, Kosha Soneji, Anthony Semaan, Steve Yu

Background: Incidentally found congenital absence of bilateral uterine arteries during preprocedure imaging for uterine artery embolization.

Case: 46y G2P0020 with a symptomatic fibroid uterus who desired uterine artery embolization for treatment. On angiogram, she had bilateral atretic uterine arteries with large, tortuous ovarian arteries supplying the uterus and fibroids. Embolization was aborted due to inability to achieve access to the ovarian arteries distal to the ovaries. Ultimately, the patient underwent an uncomplicated laparoscopic supracervical hysterectomy with resolution of symptoms.

Conclusion: Congenital bilateral uterine artery atresia is a rare occurrence. In their absence it is possible for the entire uterine blood supply to be derived from the ovarian vessels. This can present challenges for management via embolization.