Bleeding and Hysteroscopy in Uterine Myomatosis (original) (raw)
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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.
Uterine Fibroids (Leiomyomata) and Heavy Menstrual Bleeding
Frontiers in Reproductive Health, 2022
Uterine Fibroids, or leiomyomata, affect millions of women world-wide, with a high incidence of 75% within women of reproductive age. In ~30% of patients, uterine fibroids cause menorrhagia, or heavy menstrual bleeding, and more than half of the patients experience symptoms such as heavy menstrual bleeding, pelvic pain, or infertility. Treatment is symptomatic with limited options including hysterectomy as the most radical solution. The genetic foundations of uterine fibroid growth have been traced to somatic driver mutations (MED12, HMGA2, FH−/−, and COL4A5-A6). These also lead to downstream expression of angiogenic factors including IGF-1 and IGF-2, as opposed to the VEGF-driven mechanism found in the angiogenesis of hypoxic tumors. The resulting vasculature supplying the fibroid with nutrients and oxygen is highly irregular. Of particular interest is the formation of a pseudocapsule around intramural fibroids, a unique structure within tumor angiogenesis. These aberrations in vas...
Exploring uterine fibroids and its treatment in current scenario
IP International Journal of Comprehensive and Advanced Pharmacology
Uterine Fibroids (leiomyoma) are made of muscle cells and other grow tissues grow in and around of the wall of the uterus. Uterine fibroids benign tumors in women reproduction age worldwide. Many are discovered incidentally on clinically examination. Approximately 30% of women with uterine fibroids will present with severe symptoms, which can include abdominal uterine bleeding, anemia, pelvic pain and constipation. Infertility and recurrent miscarriage may also be symptoms of fibroids, depending on their location and size, especially for sub mucous and intramural myelomas distorting the uterine cavity. Current option for symptomatic fibroid treatment includes expectant medical and surgical management radiology procedures. Ultrasound can be done, when a patient is symptomatic of uterine fibroids. Fibroids are generally classified by their location; intramural fibroids, subserosal fibroids, submucosal fibroids. The cause of uterine fibroids is unknown, But research and clinical experi...
Uterine Fibroids: Retrospective Study with Analysis of Different Risk Factors
International journal of women's health and wellness, 2023
General information: Uterine fibroids are benign monoclonal neoplasms of the myometrium, representing the most common tumors in women worldwide. To date, no long-term or noninvasive treatment option exists for hormone-dependent uterine fibroids, due to the limited knowledge about the molecular mechanisms underlying the initiation and development of uterine fibroids. This paper comprehensively summarizes the recent research advances on uterine fibroids, focusing on risk factors, development origin, and pathogenetic mechanisms. Finally, future perspectives on uterine fibroids studies are summarized. Deeper mechanistic insights into tumor etiology and the complexity of uterine fibroids can contribute to the progress of newer targeted therapies. Some studies reported the association between fibroids with uterine inflammation. By considering this hypothesis, the formation and recurrence of uterine fibroids can be prevented by diagnosis and treatment of inflammation, and complications and costs can be reduced. This study aimed to evaluate the association between chronic endometritis and uterine fibroids in non-menopausal women. Aim: The purpose of this study is to investigate the clinicopathological features of patients with uterine myoma and to analyze and summarize factors affecting patient prognosis. Methods: This study retrospectively investigated records of uterine myoma patients treated at JSC Central Clinical Hospital between January 2021 and November 2022. A total of 100 patients were included in this study, including the prognosis of the patient, MuClinical and pathological characteristics, including age, average body mass index (BMI), menopausal status, average lesion diameter, presence of hypertension or diabetes mellitus, operation method, myoma type, location, and quantity, number of fibroids, and presence of pelvic adhesion were analyzed via multivariate analysis. Results: Among different contributing factors, the most common were: the erosion (43%), arterial hypertension (30.2%), anaemia (28.9%), Hepatitis (19.2%). The mean age was 47, with a maximum of 74 and a minimum of 23. Surgical intervention improved the quality of life of patients by 95%. This study showed that age equal to or greater than 60 was a risk factor affecting uterine myoma prognosis. This effect is potentially due to an age-related decline in physical and immune functions that results in a greater risk of endometrial hyperplasia caused by stimulation, as well as in greater physiological impact from surgical intervention. Conclusion: This study analyzed the pathological characteristics of patients with uterine myoma, which may help improve the accuracy of disease diagnosis. Age, are risk factors affecting the prognosis of uterine mama, and can provide a reference for clinical treatment.
Etiology and Pathogenesis of Uterine Leiomyomas: A Review
Environmental Health Perspectives, 2002
Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor-β 3, basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review.
Uterine Leiomyoma: Available Medical Treatments and New Possible Therapeutic Options
The Journal of Clinical Endocrinology & Metabolism, 2013
Context: Uterine leiomyomas (fibroids or myomas) are benign tumors of the uterus and are clinically apparent in up to 25% of reproductive-age women. Heavy or abnormal uterine bleeding, pelvic pain or pressure, infertility, and recurrent pregnancy loss are generally associated with leiomyoma. Although surgical and radiological therapies are frequently used for the management of this tumor, medical therapies are considered the first-line treatment of leiomyoma.
A Clinical, Sonological and Pathological Study of Fibroid Uterus
IOSR Journals , 2019
Background: Uterine fibroids are benign tumors arising from smooth muscle cells of myometrium. They are slow growing tumours and account for 5-20% of women in reproductive age group.Although benign they present with heavy menstrual bleeding causing substantial morbidity unless treated. Objective: The study aims to analyse clinical, sonological and pathological spectrum in cases of leiomyoma of uterus. Materials and methods: A clinical study of 50 cases of fibroid uterus was made in VGH from FEB 2015-JUNE 2016.Diagnosis was confirmed by ultrasound. The cases selected for medical management were excluded from the study. Results:The maximum incidence was seen in the age group 30-40 years with 29 cases(58%)and 6 cases (12%) in the age group 20-30 and 15 cases (30%) in the age group 40-50 years.31 cases (62%) were para 2 or more.The most common clinical presentation was menorrhagia seen in 38 cases (76%), Intramural fibroids was seen in 39 cases (78%). Hysterectomy was the most common procedure. Total abdominal hysterctomy was done in 28 cases (56%), Total abdominal hysterectomy with bilateral salpingo-oophorectomy in 17cases (34%) and Laparoscopic assisted vaginal hysterectomy was done in 1 case (2%). Conclusion: Fibroids are the most common benign tumors of the uterus in the reproductive age group. Although benign they cause heavy menstrual bleeding and appropriate, timely diagnosis and treatment is essential to reduce morbidity associated with it.
Human Reproduction Update, 2014
† Introduction † Overview of uterine fibroids Molecular etiology and potential therapeutic targets for uterine fibroids Treatment of uterine fibroids † Epidemiology, genetics and environment Finding genes for uterine fibroids Uterine fibroids and the exposure paradigm Epidemiologic insights into ethnic differences in uterine fibroid burden Risk factors for uterine fibroids in the Black Women's Health Study Race and fibroid tumor burden † Pathogenesis: growth factors, cytokines, cell signaling and the extracellular matrix Mediators and integrators of the molecular microenvironment in uterine fibroids Growth factor signaling pathways in uterine fibroids Regulation of growth factor signaling pathways in uterine fibroids by endogenous and environmental factors † Hormonal regulation and hormone receptor interactions † Developing new model systems Green tea extract for the treatment of uterine fibroids Uterine b-catenin mouse model for uterine fibroids Mouse xenograft model for human uterine fibroids
2020
Diffuse uterine leiomyomatosis (DUL) is a rare condition characterized by the presence of innumerable benign uterine leiomyomata that are 3 cm or less in diameter.1 The myomas are generally submucosal or intramural in location, ill-defined and thought to be an extreme type of multiple uterine fibroids.2 This condition is associated with severe menorrhagia and is most often seen in women of reproductive age group. There are less than 40 cases of DUL reported in modern literature. Hysterectomy has been suggested as the standard treatment as myomectomy might be unable to achieve a complete clearance and repair of the uniformly involved myometrium.3 Other treatment modalities that have been attempted include hormonal treatment4 and uterine artery embolization,5 both with limited success. However, the optimal treatment of women with DUL wishing to become pregnant is still a matter of debate. Several authors have recently proposed hysteroscopic myomectomy as a treatment for DUL in accorda...