In this article, we comment on the paper by Kakinuma et al published recently. We focus specifically on the diagnosis of uterine pseudoaneurysm, but we also review other uterine vascular anomalies that may be the cause of life-threating hemorrhage and the different causes of uterine pseudoaneurysms. Uterine artery pseudoaneurysm is a complication of both surgical gynecological and non-traumatic procedures. Massive hemorrhage is the consequence of the rupture of the pseudoaneurysm. Uterine artery pseudoaneurysm can develop after obstetric or gynecological procedures, being the most frequent after cesarean or vaginal deliveries, curettage and even during pregnancy. However, there are several cases described unrelated to pregnancy, such as after conization, hysteroscopic surgery or laparoscopic myomectomy. Hemorrhage is the clinical manifestation and it can be life-threatening so suspicion of this vascular lesion is essential for early diagnosis and treatment. However, there are other uterine vascular anomalies that may be the cause of severe hemorrhage, which must be taken into account in the differential diagnosis. Computed tomography angiography and embolization is supposed to be the first therapeutic option in most of them.

This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm (UAP), as well as an analysis of UAP etiology. This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures. The patient underwent timely relevant examinations to confirm the diagnosis, allowing for crucial time required for her treatment. In this study, the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility, suggesting that the selection and implementation of dilatation catheters are some of the predisposing factors for UAP. In conclusion, this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment, offering valuable insights for the clinical diagnosis and management of UAP.

Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection. This article discusses the case study by Kakinuma et al, which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman. Utilizing advanced imaging techniques such as ultrasound and computed tomography (CT), the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition. The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases. This article aims to expand on the study's findings, discuss the clinical implications, and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery.

This manuscript explores the case on the occurrence of uterine artery pseudoaneurysm (UAP) during hysteroscopy endometrial polypectomy and the subsequent successful treatment via uterine artery embolization (UAE). Moreover, we focus on the management and treatment options for UAP in patients of advanced maternal age. A pseudoaneurysm is an extraluminal blood collection with a disrupted flow that communicates with the parent vessel via a defect in the arterial wall. The reported case involved a 48-year-old primiparous woman who developed a UAP after uterine polyp removal. The study enhances the understanding of UAP, a rare but potentially life-threatening condition, by providing a detailed and well-documented account of the comprehensive case presentation, effective use of medical imaging techniques for diagnosis, successful postoperative patient management following UAE, and practical clinical recommendations for clinicians managing similar cases. Overall, this study highlights the importance of considering UAP as a differential diagnosis in patients with abnormal vaginal bleeding following hysteroscopic surgery. Additionally, this manuscript recommends that clinicians with a high index of suspicion for UAP promptly request ultrasonography and computed tomography to facilitate early diagnosis. UAE is suggested as a primary treatment due to its effectiveness and safety, particularly in facilities capable of avoiding hysterectomy.