Uterine fibroids as an obstacle to childbirth

A. Soloviev

doi:10.17816/jowd66618

Fibroids of the uterus with intravascular growth

Kazan medical journal ◽

10.17816/kazmj79461 ◽

2021 ◽

Vol 17 (2) ◽

pp. 219-223

Author(s):

A. I. Timofeev

Keyword(s):

High Probability ◽

Uterine Fibroids ◽

Controversial Issue ◽

Uterine Myomas

As you know, in the controversial issue of the histogenesis of uterine fibroids, the so-called. vascular theory occupies a fairly prominent place. I am among my defenders of such prominent representatives of natka as Borst, Orth, Lubagsch, Gottschalk, etc. Despite the high probability of such a histogenesis of uterine myomas, it should be noted that the growth of tumors into the lumen of the vessels is extremely rare, and only a few cases of this kind are described in the literature. Various authors, describing tumors spreading in their growth along the preexisting cavities, give them different names myoma plexiforme, Venenmyom, and R. Meyer suggests calling them myoma intravasculare.

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Incidence of complications after laparoscopic and hysteroscopic surgeries for uterine myomas

Obstetrics Gynecology and Reproduction ◽

10.17749/2313-7347.2019.13.2.095-102 ◽

2019 ◽

Vol 13 (2) ◽

pp. 95-102

Author(s):

N. K. Alizade

Keyword(s):

Postoperative Complications ◽

Transvaginal Ultrasound ◽

Uterine Fibroids ◽

Blood Analysis ◽

Uterine Myomas ◽

Rhesus Factor ◽

Post Surgery ◽

Simultaneous Operations ◽

Menstruation Disorders ◽

History Of

Aim: to assess the incidence of complications after laparoscopic and hysteroscopic myomectomy.Materials and methods. The results of 378 laparoscopic and 292 hysteroscopic surgeries for uterine fibroids (myomas) have been retrospectively analyzed. All patients were examined for their history of gynecological and concomitant non-gynecological diseases, past surgeries, and the menstrual, sexual and reproductive functions. The patients underwent clinical blood analysis, urinalysis, electrocardiography and chest X-ray test, blood group and rhesus factor determination, hemostasis assay, blood analysis for RV, HIV and tumor markers, as well as transabdominal and transvaginal ultrasound using SSD-1200 and SSD-2000 devices (Aloka Ltd, Japan). We characterized the patients by the type of surgical intervention (laparoscopic or hysteroscopic), and also by age, indications for surgery, the number of fibroids and their locations, size of the uterus, presence of extragenital and genital disorders, and also by the surgery techniques. The post-surgery complication incidence rate was calculated and expressed as percentage (%), arithmetic mean (M), and standard error of the mean (m).Results. The overall incidence of severe postoperative complications did not differ between laparoscopic (2.7 ± 0.8 %) and hysteroscopic (2.1 ± 0.8 %) operations for uterine myomas (p > 0.05). The incidence of complications was significantly higher in women operated by laparoscopy if they underwent simultaneous operations (12.3 ± 4.0 % vs. 0.6 ± 0.4 % for non-simultaneous operations), if the number of fibroids was > 4 (3.9 ± 1.4 % vs. 1.1 ± 0.8 % in those with < 4 fibroids), in the presence of anemia (8.2 ± 2.9 % vs. 1.0 ± 0.6 % in cases with no anemia), and in patients with menstruation disorders (4.9 ± 1.8 % vs. 1.3 ± 0.7 % with normal menstruation). The operated patients significantly differed by the number of uterine fibroids: the average number of fibroids was larger in those operated laparoscopically (2.9 ± 0.05 vs. 2.3 ± 0.04; p < 0.01); the proportion of patients with 4 or more fibroids was also significantly higher in those patients (53.7 ± 2.6 % vs. 30.1 ± 2.7 %; p < 0.001). The compared groups also differed in the location of their myomas.Conclusion. The risk of postoperative complications after laparoscopic surgery is relatively high if simultaneous operations take place, if the number of fibroids is ³ 4, and in the presence of anemia or menstruation disorder.

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The effectiveness of microwave endometrial ablation combined with hysteroscopic transcervical resection in treating submucous uterine myomas: A retrospective study

10.21203/rs.3.rs-705761/v1 ◽

2021 ◽

Author(s):

Toshiyuki Kakinuma ◽

Kaoru Kakinuma ◽

Ayano Shimizu ◽

Ayaka Kaneko ◽

Masataka Kagimoto ◽

...

Keyword(s):

Retrospective Study ◽

Visual Analogue Scale ◽

Analogue Scale ◽

Combined Treatment ◽

Uterine Fibroids ◽

Endometrial Ablation ◽

Additional Treatment ◽

Microwave Endometrial Ablation ◽

Uterine Myomas ◽

Transcervical Resection

Abstract Background Submucous uterine myomas can be effectively and safely treated using microwave endometrial ablation (MEA). However, recurrence is common and requires additional treatment. This study investigated the efficacy of MEA combined with transcervical resection (TCR). Methods This retrospective study included 32 women who underwent MEA in addition to TCR for submucous uterine myomas at the International University of Medicine and Welfare Hospital between January 2016 and June 2020. All patients were followed up for ≥ 6 months after the procedure. Results The 32 women had a mean age of 45.2 ± 4.3 years. The myomas had a mean major diameter of 26.3 ± 12.3 mm and a protrusion degree of 51.3 ± 11.3%. The patients reported very severe hypermenorrhea/dysmenorrhea (10/10 points on the visual analogue scale) before the procedure. After the procedure, the hypermenorrhea scores decreased to 1.2 ± 1.3 and 0.9 ± 1.3 after 3 and 6 months, respectively (both p < 0.001). The dysmenorrhea scores also decreased to 1.3 ± 1.8 and 1.3 ± 1.8 after 3 and 6 months, respectively (both p < 0.001). Circulating hemoglobin concentrations improved significantly from 8.7 ± 1.9 g/dL to 13.5 ± 1.1 g/dL (p < 0.001). The mean follow-up duration was 33.8 ± 16.8 months and 10 women (31.3%) developed amenorrhea during this period, although none experienced recurrence of hypermenorrhea. No surgical complications were observed. The patients reported being highly satisfied with the ability of the combined treatment to relieve hypermenorrhea (mean visual analogue scale score: 9.5 ± 0.8). Conclusion Reducing the size of uterine fibroids via a combination of MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas. Furthermore, the procedure’s effectiveness is complemented by the patients’ high satisfaction level.

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Management in cases of large uterine myomas in pregnancy

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2019-0059 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Aleksandra Stupak ◽

Marcin Bobiński ◽

Andrzej Miturski ◽

Barbara Kalbarczyk ◽

Anna Kwaśniewska ◽

...

Keyword(s):

Pregnant Woman ◽

Pain Control ◽

Clinical Observation ◽

Uterine Fibroids ◽

Reproductive Organs ◽

Benign Tumors ◽

Premature Delivery ◽

Case Presentation ◽

Uterine Myomas ◽

In Pregnancy

AbstractObjectivesUterine fibroids are the most common benign tumors in women of procreative age. The effects of their occurrence affect the course of pregnancy by increasing the frequency of abortions, premature delivery or premature abruption of the placenta. Medical treatment includes clinical observation, pharmacological pain control, myomectomy during pregnancy or perinatal hysterectomy.Case presentationWe present a survey of literature and the case of a pregnant woman with an enormous uterine fibroid 23×13×16 cm on the basis of which a diagnostic-therapeutic scheme for tumors of the reproductive organs during pregnancy has been developed.ConclusionsThe study presents improved recommendations for management the pregnancies in presence of the uterine myomas based on clinical practice.

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Surgical treatment of uterine fibroids: current state of the problem and own experience

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(3)-34 ◽

2018 ◽

Vol 22 (3) ◽

pp. 561-568

Author(s):

I.P. Martsynkovskyi ◽

R.P. Stashchuk ◽

O.V. Klymeniuk ◽

V.V. Levchyk ◽

M.V. Ivasiuk ◽

...

Keyword(s):

Uterine Fibroids ◽

Deficiency Anemia ◽

Advantages And Disadvantages ◽

Uterine Myomas ◽

Current State ◽

Clinical Center ◽

Surgical Methods ◽

Considerable Impact ◽

Invasive Techniques ◽

The Military

Uterine myomas are the commonest gynecological tumors, with a prevalence of 70% to 80% in women who have reached the age of 50 years. In the contingent of women aged 25 to 44 years, the incidence is 8.9-30.9/1000. The prevalence of uterine myomas increases with age, peaking in women in 40 years. A hysterectomy study has found myomas in 77% of uterine specimens. In many women myomas may be asymptomatic and are diagnosed incidentally on clinical examination or imaging. However, myomas can cause significant morbidity including menstrual abnormalities (e.g. heavy, irregular, and prolonged uterine bleeding), iron deficiency anemia, bulk symptoms (e.g. pelvic pressure/pain, obstructive symptoms), and fertility issues. Symptomatic fibroids have a considerable impact on women's quality of life as well as their productivity. The article describes an overview of modern surgical methods for treating of uterine myomas. The advantages and disadvantages of each surgical method, indications and contraindications to their use are analyzed and described. Modern minimally invasive techniques for the treatment of uterine fibroids, such as uterine artery embolization and the use of focused energy delivery systems, are described. The clinical case of nodal symptomatic uterine myoma with necrosis of the fibromatous node in a patient treated in the Military Medical Clinical Center of the Central Region is given. The patient performed extirpation of the uterus with left appendages, right uterine tube.

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Spontaneous Pregnancy following Treatment of Symptomatic Uterine Myomatosis with Ulipristal Acetate without Surgery

Obstetrics Gynecology and Reproductive Sciences ◽

10.31579/2578-8965/059 ◽

2021 ◽

Vol 5 (3) ◽

pp. 01-05

Author(s):

Vicente Spinoso Cruz ◽

Marta Colechá Morales ◽

Ligia Gil Melgosa ◽

Aida Revuelta Lopez

Keyword(s):

Uterine Fibroids ◽

Reproductive Age ◽

Fertility Treatment ◽

Benign Tumors ◽

Women Of Reproductive Age ◽

Ulipristal Acetate ◽

Uterine Myomas ◽

Spontaneous Pregnancy ◽

Future Fertility ◽

Effective Option

Uterine fibroids are the most frequent gynaecological benign tumors in women of reproductive age and can cause infertility. Their treatment may be medical, surgical or a combination of both, but they may compromise future fertility in patients in which their wish to conceive has not yet been fulfilled. In this report we present two patients with symptomatic uterine myomas and who wanted to preserve their fertility. Treatment with one or two 12-week courses of 5 mg of ulipristal acetate was prescribed. A decrease in the size of the fibroids was observed, along with adequate control of the symptoms. Spontaneous pregnancies led to two live births without significant complications. Treatment with Ulipristal Acetate may be an effective option to take into account in the management of patients with symptomatic uterine fibroids who refuse surgery or in those in which it is contraindicated and who wish to preserve their fertility.

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Three dimensional ultrasound- its use in defining and prognosticating fibroid associated with pregnancy: one picture is worth more than a thousand words

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181954 ◽

2018 ◽

Vol 7 (5) ◽

pp. 2046

Author(s):

Aarti Deenadayal Tolani ◽

Suhasini Donthi ◽

Kadambari . ◽

Mamata Deenadayal

Keyword(s):

Early Diagnosis ◽

Embryo Implantation ◽

Three Dimensional ◽

Uterine Fibroids ◽

Cost Effective ◽

Reproductive Age ◽

Uterine Myomas ◽

Uterine Anomalies ◽

High Resolution Images ◽

Implantation Rates

Uterine fibroids are most frequent benign growths occur in female reproductive age with the frequency of 20-40%. The fibroid incidence in pregnancy estimated to be 0.1 to 3.9%. They affect the female fertility and embryo implantation rates after the assisted reproductive treatments. Although most of the uterine myomas are asymptomatic during pregnancy, seldom they lead to the various complications that harm the pregnancy. Henceforth it is advisable to diagnose the uterine myomas at early stages. Three-dimensional ultrasonography is excellent equipment producing high-resolution images in different panels. It is easily accessible, cost-effective and offers benefits for early diagnosis of uterine anomalies. In this case report, we emphasized on the early diagnosis of the uterine fibroid associated pregnancy that enabled the physician to manage the pregnancy without complications.

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