• Xiuchun Yang, Wenhui Zhao, Shujuan Chen, and Jinhong Yang.
• School of Nursing, Weifang Medical University, Weifang, People's Republic of China.
• Medicine (Baltimore). 2024 Apr 5; 103 (14): e37701e37701.

RationaleHysterectomy after microwave ablation (MWA) is more difficult than conventional surgery which increases the probability of postoperative complications due to MWA's collateral thermal damage to nearby intestines. Here we report a case of multiple postoperative complications after hysterectomy following MWA.Patient ConcernsA 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy.Diagnoses1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation.InterventionsThe patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation.OutcomesAfter 48 days of comprehensive treatment, the patient was cured and discharged.LessonsMicrowave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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