scholarly journals Conservative surgical treatment of uterine fibroids

2014 ◽  
Vol 61 (4) ◽  
pp. 11-16 ◽  
Author(s):  
Radmila Sparic ◽  
Lazar Nejkovic ◽  
Dragoslav Mutavdzic ◽  
Antonio Malvasi ◽  
Andrea Tinelli
Keyword(s):  
Uterine Fibroids ◽  
Reproductive Function ◽  
Maximum Size ◽  
Limiting Factor ◽  
Childbearing Age ◽  
Proper Patient Selection ◽  
Submucosal Fibroids ◽  
Benign Tumours ◽  
Cesarean Myomectomy

Fibroids are the most common benign tumours of the genital organs in women of childbearing age, causing significant morbidity and largely disturbing quality of life. Myomectomy is a option of choice for women who want to preserve reproductive function. Conventional myomectomy via laparotomy is commonly used for large subserosal and intramural fibroids and in cases of a large number of fibroids. Number, size and location of fibroids in most cases do not represent a limiting factor for conventional myomectomy. Vaginal myomectomy is possible in cases of nascent submucosal fibroids. Laparoscopic myomectomy is an option for patients with smaller uterus, as the size of the uterus could represent a limiting factor for this approach. Hysteroscopic resection of submucosal fibroids is the method of choice for most patients with submucous fibroids. There is no consensus yet on the maximum size and type of fibroids that can be operated with this approach. Myoma pseudocapsule research during the past decade led to introduction of a surgical technique called "intracapsular myomectomy", as a method which spares the pseudocapsule as an important structure for optimal myometrial healing after myomectomy, positively affecting future reproductive function. The clinical rationale for intracapsular myomectomy can be applied to all myomectomies, therefore it has been used both for laparoscopic and laparotomic myomectomy, as well as for cesarean myomectomy. Several studies demonstrated that CM is probably safer procedure than previously believed. CM is justifiable when performed following proper patient selection by experienced surgeons.

scholarly journals Specific Aspects of Life Quality Estimation and Ways of Rehabilitation in Women Who Underwent Uterine Surgery

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
H. M. Havrylyuk ◽  
O. M. Makarchuk
Keyword(s):  
Blood Supply ◽  
Ovarian Function ◽  
Internal Iliac Artery ◽  
Life Quality ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Internal Iliac

Recently, it has been noticed a great number of uterine fibroids in women with unrealized reproductive function; moreover, the number of combined forms of hyperplastic processes of the reproductive system in 20-25% of women under 30 years of age and 60% of women over 40 years of age is constantly growing creating a favourable background for cancer. It is also known that women with hyperplastic processes suffer from psycho-emotional disorders both before surgeries and after surgical recovery; many of them are diagnosed with adjustment disorder. As many researches note, the main psychotherapeutic aspects include passive view of life, increased anxiety, tendency to dependent behaviour, rejection of own body, protective behaviour and problems with self-assessment. It should also be noted that a comprehensive study of clinical and laboratory data and subjective criteria of life quality is essential in assessment of the feasibility of hysterectomy in women of reproductive age, even if they do not plan to bear children in the future. The objective of the research was to estimate life quality as well as to improve the system of dispensary observation and rehabilitation of women who underwent uterine surgery.Materials and methods. There was performed a comprehensive examination and surgical treatment of 60 women of reproductive age with uterine fibroid who underwent hysterectomy with preservation of appendages. We used modern high quality endocrinological and instrumental techniques. The assessment of the received data was made immediately after surgery, 6 and 2 months, 3 and 5 years after surgery. Quality of life was studied on the basis of a comprehensive assessment using the modified scale of the Nottingham Health Profile and the study of such important indicators as energy, sleep, emotional reactions, social isolation, physical activity, pain. All statistical analysis was performed using a standard package “Statistica for Windows – 6.0”.Results and discussion. On the basis of anamnestic data of patients we revealed health deterioration with high rates of liver and gastrointestinal tract disorders, metabolic disturbances (obesity, hypertensive disorders, fibrocystic breast disease), metabolic-endocrine changes and surgery. Reproductive health in women with uterine fibroid was characterized by long establishment of regular menstrual cycle, its breach in the period of puberty, inflammatory diseases of the genital organs, benign ovarian tumours and their surgical removal, inadequate reproductive behaviour with absent or delayed implementation of reproductive function and induced abortion. 12 months and especially 5 years after surgery there was noticed a progressive deterioration of the ovarian function, which was reflected as the reduction in their volume due to the reduction in the number and size of follicles, deterioration of blood supply to the ovaries, decreased blood flow in the internal iliac artery basin. It should also be noted the progressive hypestrogenism; in addition, there was a clear correlation with the age of the woman, who underwent surgical operation. Changes in life quality of patients with hyperplastic processes of the uterus were manifested in the postoperative period as follows: a decrease in physical activity (43.33% of cases), increased sexual dysfunction (36.66%), inhibition of mental state, conflict-orientated social behaviour, weakening of role functions and subjective deterioration of health and life quality (51.66% of cases).Conclusions. Thus, surgery on uterine fibroids with total or subtotal hysterectomy contributes to interference in a complex neuroendocrine interaction between hypothalamus, pituitary, ovaries, adrenal cortex, thyroid gland and affects the blood supply, innervation, and lymph efflux in the pelvic floor; therefore, postoperative syndromes are polyglandular and polysystemic. Long-term effects after surgery are accompanied by progressive hypestrogenism, decrease in the ovarian function (the reduction in their volume observed during ultrasound examination), reduction in the number and size of follicles, deterioration of blood supply to the ovaries, low blood supply to the internal iliac artery basin.

scholarly journals Improvement in Quality of Life After Myomectomy

2020 ◽  
Author(s):  
Ehab Helmy Abdel Malek Fahmy ◽  
Constance Liew Sat Lin ◽  
Alvin Oliver Payus ◽  
Rhanye Mac Guad ◽  
May Zaw Soe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Menstrual Cycle ◽  
Pelvic Pain ◽  
Uterine Fibroids ◽  
Heavy Menstrual Bleeding ◽  
Anxiety And Depression ◽  
Poor Sleep ◽  
Childbearing Age ◽  
Menstrual Disorder

Dysmenorrhea is one of the leading causes of pelvic pain and menstrual disorder among women during childbearing age. The burden of dysmenorrhea is greater than any other gynaecological complaint. Some women have severe dysmenorrhea which renders them incapacitated for days each menstrual cycle requiring absence from study or duty, frequently requiring pain killer, restriction of daily performance, poor sleep, negative moods such as anxiety and depression. A 31-year-old female presented with severe dysmenorrhea and heavy menstrual bleeding (HMB) as a cause of multiple uterine fibroids, underwent surgeries to remove 100 fibroids from her uterus which has improved her quality of life, eliminating her dysmenorrhea and menstrual abnormalities.

scholarly journals Benign metastasizing leiomyoma – a case of benign metastasis

JRSM Open ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 205427042110644
Author(s):  
Diogo André ◽  
Fabiana Gouveia ◽  
Helena Luís ◽  
Mónica Caldeira ◽  
Filipe Perneta ◽  
...  
Keyword(s):  
Abdominal Mass ◽  
Female Genital Tract ◽  
Uterine Fibroids ◽  
Pulmonary Nodules ◽  
Rare Condition ◽  
Childbearing Age ◽  
History Of ◽  
Metastasizing Leiomyoma ◽  
Benign Tumours ◽  
Abdominal Lesions

Leiomyomas are benign tumours of smooth muscle cells that most often affect the female genital tract, but their metastasis to extra-uterine locations represent rare, yet misunderstood phenomena. The authors present a clinical case of a 42-year-old woman, who underwent a hysterectomy 15 years ago due to myomas, admitted with multiple pulmonary nodules and abdominal mass, diagnosed by imaging tests, in the context of haemoptysis. The anatomopathological exams of the pulmonary and abdominal lesions were compatible with the diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare condition that particularly affects women of childbearing age, with a history of hysterectomy for uterine fibroids. Hence, this entity must be considered in the differential diagnosis of women with pulmonary nodules of uncertain aetiology.

scholarly journals Fibroids and Infertility

2021 ◽  
Author(s):  
Juan Luis Giraldo Moreno ◽  
Susana Salazar López
Keyword(s):  
Negative Impact ◽  
Embryo Implantation ◽  
Uterine Fibroids ◽  
Abnormal Uterine Bleeding ◽  
Open Approach ◽  
Pelvic Tumors ◽  
Increased Risk ◽  
Submucosal Fibroids ◽  
Intramural Fibroids

Uterine fibroids (also known as leiomyomas or myomas) are the most common pelvic tumors, affecting more than 70% of women over 70 years of age and although most are asymptomatic, some women may experience symptoms, depending on their location and size, which can alter your quality of life, such as abnormal uterine bleeding, anemia, pelvic pain and pressure, dyspareunia, increased urinary frequency and constipation. Its relationship with infertility has been controversial and, although insignificant for subserous fibroids, it appears that submucosal and intramural fibroids that distort the endometrial cavity can affect embryo implantation and are associated with an increased risk of early pregnancy loss. Its treatment will depend on the patient’s symptoms, size, location, whether it is one or multiple, and whether or not she suffers from infertility. It is clear that submucosal fibroids have a negative impact on fertility and with respect to intramural fibroids it is known that fibroids larger than 4 cm alter the probability of pregnancy, however there are studies that show that even smaller or multiple fibroids could affect pregnancy rates. There are multiple options for the treatment of fibroids; however, patients who are candidates for expectant, medical or surgical management should be individualized, and especially if they are going to be taken to surgery, an excellent mapping of fibroids prior to surgical intervention is recommended. Minimally invasive surgery continues to be the approach of choice, it should be left for the open approach in cases in which Laparoscopy is contraindicated or the patient with multiple myomatosis.

Modern approaches to the prevention and treatment of alterations in reproductive health in women with somatoform disorders and autonomic homeostasis

2016 ◽  
pp. 98-101
Author(s):  
Vl.V. Podolsky ◽  
◽  
V.V. Podolsky ◽  
Keyword(s):  
Reproductive Health ◽  
Hormonal Regulation ◽  
Preventive Measures ◽  
Somatoform Disorders ◽  
Emotional Health ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Epidemiological Studies ◽  
Prevention And Treatment ◽  
Artificial Abortion

The objective: the developing of a system of preventive measures and principles of pregravid preparation for women with somatoform disorders and violation of autonomic homeostasis (VAH), in which observed changes in reproductive health (CRH) in the shape of states after undergoing artificial abortion, infertility and uterine fibroids. Patients and methods. Conducted clinical and epidemiological studies in the population of women of fertile age (WFA) allowed identifying for further examination of women with CRH in the form of state after undergoing artificial abortion, infertility and uterine fibroids in women with VAH. Further women were examined, in particular the conducted clinical and instrumental methods of research; determined the state of autonomic homeostasis and psycho emotional health of the biotopes of the organism, immunity; analyzed the hormonal regulation of the menstrual cycle; performed genetic studies and determined the morphofunctional state of reproductive system. Results. The most frequent complications during pregnancy in women who had CRH in history in the form of abortions, infertility and uterine fibroids and in the background of the PAF, there was a threat of interruption of pregnancy (often in I and II trimester – 56%) and preterm delivery (21%). The study of the catamnesis of further reproductive health found that in the case of well-conducted therapeutic measures in women undergoing artificial abortion, had infertility and uterine leiomyoma in the background of VAH, restore reproductive function, and in 82% of cases occurred a pregnancy. Conclusion. The the provided study of reproductive health, and state of various organs and systems of fertile aged women with somatoform disorders and violations of the autonomic homeostasis allowed to develop preventive measures for these women and pregravid preparation with the inclusion to the therapy Magnesium and vitamins (Magne-В6®). Key words: somatoform disorders, violation of autonomic homeostasis, changes in reproductive health, prevention and treatment, women of fertile age, Magne-В6®.

scholarly journals Impact of Contraception on Uterine Fibroids

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 717
Author(s):  
Katarzyna Kwas ◽  
Aleksandra Nowakowska ◽  
Angelika Fornalczyk ◽  
Magda Krzycka ◽  
Anna Nowak ◽  
...  
Keyword(s):  
Protective Factor ◽  
Hormonal Contraception ◽  
Uterine Fibroids ◽  
Study Data ◽  
Study Group ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Prospective Survey ◽  
Hormonal Dependence ◽  
Control Study

Background and Objectives: Uterine fibroids develop in 25–40% of women of childbearing age; however, there are discrepancies resulting from population and socioeconomic differences. The pathogenesis of fibroids is not clear. The aim of the study was to assess the potential connection between the use of oral contraceptives and the occurrence of uterine fibroids in women of childbearing age. Materials and Methods: In this prospective, survey, case–control study, data were collected from Caucasian female patients (mean age = 30) using a questionnaire concerning the onset, duration and form of hormonal contraception, and medical and obstetrical history. The questionnaires were handed personally to hospitalized patients as well as distributed through Google forms on social media. Results: In a study group (n = 140) of patients using hormonal contraception, 37.8% of them were diagnosed with uterine fibroids, whereas among the patients not using hormonal contraception (n = 206), uterine fibroids were diagnosed in 59.6% of the patients. The most common hormonal contraception was two-component hormonal tablets used by 93.3% of the patients. Taking contraceptives was a uterine fibroids protective factor (OR = 0.4, p = 0.007). In the study group, 5.5% of the patients were pregnant and 60.42% were diagnosed with uterine fibroids (OR = 4.4, p < 0.000001). Conclusion: Contraception was found to be a protective factor for uterine fibroids among the women surveyed. The presented data confirm the theory about the hormonal dependence of uterine fibroids.

scholarly journals Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: implications for advancing a health equity agenda, a mixed methods study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Christophe Millien ◽  
Anatole Manzi ◽  
Arlene M. Katz ◽  
Hannah Gilbert ◽  
Mary C. Smith Fawzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Black Women ◽  
Uterine Fibroids ◽  
Mixed Methods Study ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Cross Sectional ◽  
Women's Lives

Abstract Background Uterine fibroids, the most common cause of gynecologic surgery, have a reported cumulative incidence of 59% among Black women in the U.S. Uterine fibroids negatively impact the quality of women’s lives. No study has been found in the literature about fibroids in Haiti. We conducted a mixed methods study to assess the burden and risk factors of uterine fibroids, as well as their effects on women’s quality of life. Methods A convergent mixed methods study was conducted between October 1, 2019 and January 31, 2020 at MUH’s (Mirebalais University Hospital) OB-GYN outpatient department. Quantitatively, in a cross-sectional study 211 women completed consecutively a structured questionnaire. In-depth interviews with 17 women with fibroids and 7 family members were implemented for the qualitative component. Descriptive statistics were calculated for clinical and social demographic variables. Logistic regression was performed to examine associations between fibroids and related risk factors. An inductive thematic process was used to analyze the qualitative data. A joint display technique was used to integrate the results. Results Of 193 women analyzed 116 had fibroids (60.1%). The mean age was 41.3. Anemia was the most frequent complication— 61 (52.6%). Compared to women without uterine fibroids, factors associated with uterine fibroids included income decline (AOR = 4.7, 95% CI: 2.1–10.9, p = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, p = 0.005), and family history with uterine fibroids (AOR = 4.6, 95% CI: 1.6–13.6, p = 0.005). In contrast, higher level of education and micro polycystic ovarian syndrome were associated with lower prevalence (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.021) and (AOR = 0.2, 95% CI: 0.1–0.97, p = 0.044), respectively. The qualitative findings delineate how contextual factors such as health system failures, long wait times, gender inequality and poverty negatively affect the quality of women’s lives. The poverty cycle of uterine fibroids emerged. Conclusions A vicious cycle of poverty negatively impacts access to care for uterine fibroids in Haiti. Health insurance, social support, and income generating activities may be keys to promote social justice through access to adequate care for women with uterine fibroids in Haiti.

scholarly journals Surgical management of brain metastases

2007 ◽  
Vol 22 (3) ◽  
pp. 1-7 ◽  
Author(s):  
Moksha G. Ranasinghe ◽  
Jonas M. Sheehan
Keyword(s):  
Brain Tumors ◽  
Systemic Disease ◽  
Postoperative Management ◽  
Study Data ◽  
Preoperative Imaging ◽  
Metastatic Brain Tumors ◽  
Patients With Cancer ◽  
Proper Patient Selection ◽  
Positive Effect

✓Metastatic brain tumors continue to increase in incidence as patients with cancer live longer. The options for management continue to evolve as well, with advances in radiation-based treatment, chemotherapy, and surgery. Although metastatic brain tumors are frequently treated without surgical intervention, there continues to be a significant role for surgery in caring for patients with these lesions. Study data have proven that surgery has a positive effect on survival and quality of life in properly selected patients. Those with a suitable age, functional status, systemic disease control, and several metastases may be suitable for surgical treatment. Advances in preoperative imaging and planning as well as intraoperative surgical adjuncts have lowered the morbidity associated with resection. With proper patient selection and operative and postoperative management, resection continues to play a significant and evolving role in the care of patients with metastatic brain tumor.

Assessment of Environmental Quality of Soil Fertilized Grapefruit Trees with Municipal Sewage Sludge

2013 ◽  
Vol 671-674 ◽  
pp. 2736-2741
Author(s):  
Yin An Ming ◽  
Tao Tao
Keyword(s):  
Sewage Sludge ◽  
Environmental Quality ◽  
Sewage Treatment ◽  
Sewage Treatment Plant ◽  
Treatment Plant ◽  
Land Application ◽  
Municipal Sewage ◽  
Municipal Sewage Sludge ◽  
Limiting Factor

To reuse municipal sewage sludge safely, experiment was carried out on grapefruit trees fertilized with composted sludge from Shiweitou Sewage Treatment Plant in Xiamen City of China, and a method was introduced of how to assess the environmental quality of grapefruit trees soil fertilized with sludge by Set Pair Analysis (SPA) model. The results showed that the soil in the surface layer (0-15cm) and the deeper layer (15-30cm) was less clean, and the environment of soil was not polluted. Thus it was feasible to use sludge as fruit fertilizer. The maximum service life of sludge for continuous land application was estimated by taking Cd as the limiting factor, which would provide scientific guide and technical support for safe land application of sludge.

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