Health care resource use for uterine fibroid tumors in the United States (original) (raw)
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Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center
Journal of therapeutic ultrasound, 2014
The objective of the study was to describe our early experience with a comprehensive uterine fibroid center and report our results in women seeking a second opinion for management of symptomatic uterine leiomyoma. We performed a HIPAA-complaint, IRB-approved retrospective study of women seeking second opinion for management of uterine fibroids at our multidisciplinary fibroid treatment center in a tertiary care facility from July 2008 to August 2011. After a review of patients' history, physical examination, and magnetic resonance imaging (MRI) findings, treatment options were discussed which included conservative management, uterine-preserving options, and hysterectomy. We performed Fisher's exact test for categorical variables between the cohort that did or did not undergo a uterine-preserving treatment. Differences were considered significant at p < 0.05. The mean age of the 205 patient study…
Uterine fibroid treatment patterns in a population of insured women
Fertility and Sterility, 2009
Objective: To profile women treated for uterine leiomyomas who are covered by commercial insurance from large, self-insured employers in the United States. Design: Retrospective, observational study. Setting: Inpatient, outpatient, and prescription drug experience of women with employer-sponsored insurance in the United States. Patient(s): Data were obtained from the MarketScan insurance databases for 1999 through 2004 and weighted to represent the population of women with employer-sponsored health insurance in the United States. Intervention(s): None. Main Outcome Measure(s): The proportion of women with clinically significant leiomyomas was determined in each year, based on inpatient and outpatient medical claims with diagnostic codes indicating leiomyoma. Patient characteristics, comorbidities, prescription drug treatments, and surgical interventions were profiled in 2004. Result(s): Approximately 1% of women had clinically significant leiomyomas. Comorbid genital or menstrual conditions were common and much more prevalent for women with leiomyomas. Of women with leiomyomas, 18.4% received no surgical or prescription drug treatment, whereas 16.8% received only surgical treatment, 22.4% received only prescription drug treatment, and 42.4% received both. Hysterectomy was the most common surgical treatment. Conclusion(s): Generalizing from this sample, we estimate that 443,445 women with employer-sponsored insurance in the United States had clinically significant leiomyomas in 2004. (Fertil Steril Ò 2009;91:566-74.
The estimated annual cost of uterine leiomyomata in the United States
American Journal of Obstetrics and Gynecology, 2012
Objective-To estimate the total annual societal cost of uterine fibroids in the United States, based on direct and indirect costs, including associated obstetric complications. Study Design-A systematic review of the literature was conducted to estimate the number of women seeking treatment for symptomatic fibroids annually, the costs of medical and surgical treatment, work lost and obstetric complications attributable to fibroids. Total annual costs were converted to 2010 U.S. dollars. A sensitivity analysis was performed.
Therapeutic management of uterine fibroid tumors: updated French guidelines
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2012
The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen-progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids.
Uterine leiomyomata: a five year clinicopathological review in Zaria, Nigeria
Nigerian Journal of Surgical Research, 2006
Background: Uterine Leiomyomata (uterine fibroids) are common gynaecologic conditions affecting mainly women in the reproductive age group. Fibroids are associated with many other distressing gynaecologic conditions like menorrhagia, infertility, lower abdominal swelling and discomfort. Methods: This is a retrospective clinicopathological analysis uterine leiomyomata a five-year period (1996 -2000). The information required was retrieved from histology bench books and request cards. Results: 209 cases were analysed, 62.7% from myomectomy 37.3% following hysterectomy. Younger patients opted for myomectomy possibly in other to allow them complete their family sizes. Uterine fibroids were commoner in the third to fourth decade of life.The nulliparous women to had a higher incidence of uterine fibroid (60.6%) in 71 cases analysed whose parity were known. Lower abdominal swelling is the commonest presenting complaint (48.8%), followed by menorrhagia and infertility accounting for 35.4% and 30.6% respectively. Hyaline degeneration was the commonest degenerative change observed (57.9%). Three cases (1.4%) had necrosis. Nineteen cases were observed to be associated with other co-existing lesions, of which 52.6% occur with fibroid polyps. Adenomyosis accounted for 36.8% and one case each of metastatic carcinoma and interligamentary fibroids. Adequate clinical information and brief surgical procedure on request cards were lacking in most cases. Conclusion: Uterine fibroids are common conditions affecting women in their reproductive age group, which corresponds with economically viable age group. This condition is associated with significant morbity and attention needs to be focused on it.
Journal of the National Medical Association, 2005
To analyze the impact of patient and organizational characteristics on surgical treatment patterns for patients with uterine fibroids. Unadjusted means and percentages were calculated from a population-based inpatient sample (HCUPNIS). Multiple logistic regression analysis was used to estimate the prevalence odds ratios for the association of uterine fibroid treatments and covariates of interest. More than 1.2 million patients with a primary diagnosis of uterine fibroids were treated from 1998 to 2002. Of these, 84.4% received a hysterectomy and 12.3% received a myomectomy. Total abdominal hysterectomy was the most common procedure. The number of supracervical hysterectomies increased 18.1% over the five-year period. Black women and Asians/Pacific Islanders were more likely than white women to receive a myomectomy. All types of hysterectomies were more common in Medicaid patients compared with private/HMO patients. With the exception of patients in ZIP codes with a median income of ...
Fibroids (uterine myomatosis, leiomyomas)
Clinical evidence, 2007
IntroductionBetween 5-77% of women may have fibroids, depending on the method of diagnosis used. Fibroids may be asymptomatic, or may present with menorrhagia, pain, infertility, or recurrent pregnancy loss. Risk factors for fibroids include obesity, having no children, and no long-term use of the oral contraceptive pill. Fibroids tend to shrink or fibrose after the menopause.Methods and outcomesWe conducted a systematic review and aimed to answer the following clinical questions: What are the effects of: medical treatment alone; preoperative medical treatments for women scheduled for surgery; and surgical treatments in women with fibroids? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). ResultsWe found 41 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.ConclusionsIn this systematic review we present information relating to the effectiveness and safety of the following interventions: gonadorelin analogues (with progestogen, raloxifene, tibolone, or combined oestrogen-progestogen); hysterectomy (plus oophorectomy); hysteroscopic resonance-focused ultrasound; laparoscopic myomectomy; laparoscopically assisted vaginal hysterectomy; rollerball endometrial ablation; thermal balloon ablation; thermal myolysis with laser; total abdominal hysterectomy; total abdominal myomectomy; total laparoscopic hysterectomy; total vaginal hysterectomy.
The health disparities of uterine fibroid tumors for African American women: a public health issue
2013
Uterine fibroid tumors (leiomyomas) are the most common benign pelvic tumors in women and are the major indication for hysterectomy. Fibroid tumors are more common and more severe among African American women. Although this disease disproportionately affects the African American population, we understand little about what causes the disparity. Fibroid tumors should be considered a public health issue, given the magnitude of the problem and the costs of health care for this disease. In this review, we examine the burden of disease from fibroid tumors in the African American population and review the natural history, diagnosis, and treatment of uterine fibroid tumors, with emphasis on how these can differ, depending on race. We also focus on the socioeconomic burden caused by the disease and describe the anticipated influence of new health care reforms and funding mechanisms for fibroid tumor research.
Guideline No. 389-Medical Management of Symptomatic Uterine Leiomyomas – An Addendum
Journal of Obstetrics and Gynaecology Canada, 2019
It is SOGC policy to review the content 5 years after publication, at which time the document may be reaffirmed or revised to reflect emergent new evidence and changes in practice. CHANGE IN PRACTICE 1. Prolonged medical management of fibroid symptoms is safe and effective. 2. Women treated with ulipristal acetate should undergo liver monitoring. 3. Attempts should be made to correct anemia (hemoglobin <120) prior to elective gynaecologic surgery. This Addendum has been prepared by the authors, reviewed by the Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Gynaecology and Guideline Management and Oversight Committees, and approved by the Board of the SOGC.
Uterine fibroids: A clinical review
BJOG: An International Journal of Obstetrics and Gynaecology, 1990
2&25% of women over the age of 30 years (Whitfield 1986; Editorial 1986). Fibroids constitute a major public health cost to the community in terms of outpatient attendances and hospital costs for surgery of this disease. In Australia 40% of hysterectomies are reported performed because of fibroids, with costs totalling approximately 100 million dollars per year in direct hospital charges, outpatient attendances, general practitioner consultations and other support services (Opit & Gadiel 1982). In addition to these financial concerns, women are increasingly searching for alternatives to hysterectomy for fibroid disease. Increasing gynaecological knowledge, acquired through schools and the media, has raised the ability of women to choose whether hysterectomy is performed (Domenighetti et al. 1988). This review discusses recent advances in the understanding of the aetiology of these tumours, their major clinical features and both their medical and surgical management. Special attention will be given to medical advances using luteinizing hormone-releasing hormone (LHRH) analogues, and new surgical techniques of laser and hysteroscopic resection. Aetiology Why these tumours form is unknown. From clinical and epidemiological surveys in the USA it is known that fibroids are 3-9 times more com