Frequency, Complications and Outcomes of Myomectomy in Reproductive Age Women: Retrospective Analysis and Expert Opinion

2017 ◽  
Vol 9 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Alexander A. Popov ◽  
Anton A. Fedorov ◽  
Ekaterina A. Loginova
Keyword(s):  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Medical Center ◽  
Uterine Fibroids ◽  
High Technology ◽  
Reproductive Age ◽  
Newly Diagnosed ◽  
Female Population ◽  
Reproductive Age Women ◽  
Uterine Scar

The incidence of uterine fibroid in the general female population is estimated at 20%-25%. In 2008, a study involving 145 gynecologists from a few large Russian cities demonstrated that the majority of the respondents had to handle from 10 to 30 (mean 20) women with fibroid every month. Only 28.8% of the patients had newly diagnosed uterine fibroids. Surgical treatment was recommended to 29.8% of the women. A few variants of myoma treatment are distinguished. Fortunately, over 40% of these tumors are asymptomatic. We performed a retrospective analysis of 218 patients submitted to myomectomy in our medical center between 2011 and 2013. In 149 cases (68%) myomectomy was conducted as a step of preparation for pregnancy. The pregnancy rate was 51.6%. A single (1.3%) complication in the form of uterine scar rupture was documented in week 34 of pregnancy. In our opinion, myomectomy is a high-technology operation that must be performed strictly based on the principle of “best” surgery for the “best” patient.

scholarly journals Updated Costs of Uterine Fibroid Treatments Including Focused Ultrasound Surgery

2018 ◽  
Author(s):  
Bijan J. Borah ◽  
Elizabeth A. Stewart
Keyword(s):  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Invasive Treatment ◽  
Ultrasound Surgery ◽  
Non Invasive ◽  
Focused Ultrasound Surgery ◽  
Reproductive Age Women

Uterine leiomyomas (fibroids) affect 20–40% of reproductive age women and are the major indication for hysterectomy. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a new, potentially disruptive, non-invasive and uterine-sparing treatment option that has been shown to yield similar or better clinical outcomes than other uterine-sparing interventions. However, the costs of MRgFUS and other minimally-invasive treatment options have not been studied using US practice data. This study attempts to fill this void. And since uterine fibroids are the first FDA-approved indication for MRgFUS treatment, this study may also have implications for other indications which are now investigational.

scholarly journals Black Women’s Psychosocial Experiences with Seeking Surgical Treatment for Uterine Fibroids: Implications for Clinical Practice

2020 ◽  
Author(s):  
Brianna N VanNoy ◽  
Lisa Bowleg ◽  
Cherie Marfori ◽  
Gaby Moawad ◽  
Ami R. Zota
Keyword(s):  
Social Networks ◽  
Surgical Treatment ◽  
Black Women ◽  
Medical Center ◽  
Academic Medical Center ◽  
Uterine Fibroids ◽  
Medical Mistrust ◽  
Management Decisions ◽  
Management Options ◽  
Psychosocial Experiences

Abstract Background Black women are disproportionately impacted by uterine fibroids and are more likely to undergo surgical treatment for fibroids compared with non-Black women. However, few studies have characterized the psychosocial experiences of Black women seeking treatment for fibroids. This study aimed to identify factors that shape Black women’s fibroid management decisions; explore how discrimination based on race, class, and gender feature in treatment-seeking experiences; and compare experiences by age and socioeconomic status (SES). Methods We conducted semi-structured interviews with 37 Black premenopausal women, undergoing either a hysterectomy or myomectomy for fibroids at an academic medical center. We used a thematic analysis to code transcripts and identify themes. Results Participants were predominately single, highly educated, and privately insured. Respondents reported that patient-doctor interactions, support from social networks, fertility consequences, and fear of fibroid malignancy influenced their fibroid management decisions. Their knowledge and perceptions of fibroids were also influenced by social and community norms and differed by SES; women of higher SES had greater fibroid awareness than women of lower SES. Discrimination was discussed in the context of historical inequity against Black women, with one participant questioning whether Black women were valued less in clinical settings compared with non-Black women. While several women discussed positive experiences seeking fibroids care, others expressed medical mistrust or said that alternative management options were not offered by clinicians. Conclusions Fibroid management decisions were influenced not only by individual-level interactions with clinicians and social networks, and concerns about fertility and fibroid malignancy, but also by broader social and historical conditions. These findings suggest that clinicians should deliver culturally-competent gynecologic care that centers the voices of Black women and acknowledges the diverse perspectives and perceptions that Black women may have when seeking fibroid treatment.

An Innovative Approach to Studying the State of the Uterine Scar after Cesarean Section on the Basis of a Comparative Study

2021 ◽  
Vol 76 (5) ◽  
pp. 429-435
Author(s):  
Alexander N. Strizhakov ◽  
Irina V. Ignatko ◽  
Anastsia A. Churganova ◽  
Alexandr G. Aslanov
Keyword(s):  
Connective Tissue ◽  
Cesarean Section ◽  
Physical Model ◽  
Morphological Study ◽  
Medical Center ◽  
Scar Tissue ◽  
The State ◽  
Reproductive Age ◽  
Natural Childbirth ◽  
Uterine Scar

Background. Today we have not really highly informative methods for assessing the state of the uterine scar. This fact does not allow us to formulate clear selection criteria for spontaneous delivery for patients who had cesarean section (CS). The result of the formulated problem is not only an increase in the frequency of repeated abdominal delivery, but also a fivefold increase in the risks of intraoperative and postoperative complications for women of reproductive age. Aims explore the property, structure and morphological features of the myometrial scar tissue by developing a physical model based on morphological predictors. Materials and methods. The study included 49 women who ahead a second caesarean section in the maternity hospital at the S.S. Yudin state medical center. The patients had scar tissue excised in the lower uterine segment and the resulting biopsies were divided into 2 fragments. The first fragment of biopsies was necessary for performing a morphological study, based on the results of which randomization was carried out into groups. The main group included 24 fragments, where the scar tissue was well-established, and the comparison group included 25 fragments, where according to morphological research, signs of its insolvency were revealed. Further assessment of the scar state was performed using the second fragment of biopsies by creating a physical model of the study, on the basis of which the dependence of elongation on the applied force was estimated. The study was conducted in the laboratory of scientific research on the development of bioprostheses of the CSSC A.N. Bakuleva. Results. Based on a morphological study, it was confirmed that the failure of the scar is based on the disorganization of connective tissue, indicating the possible presence of undifferentiated connective tissue dysplasia for the patient. The physical model of the study demonstrated that the presence of such a difficult-to-diagnose pathology leads to a decrease in the elasticity, and therefore-the strength and elasticity of the scar on the uterus. Conclusions. For this period of time, we need to improve methods for assessing the condition of the uterine scar in order to resolve the issue of the possibility of conducting natural childbirth for patients after undergoing CS surgery. It is possible that the created physical model will be able to evaluate the predictive ability of ultrasonic elastography within the framework of this problem. It is important to remember that scar formation is the final stage of regeneration, therefore, the maximum number of answers to a detailed study of morphological and immunohistochemical features of the myometrium, as it is the primary matrix on which will be the formation of scar tissue.

Surgical Treatment Patterns for Women with Newly Diagnosed Uterine Fibroids: Trends from 2010-2014

2016 ◽  
Vol 23 (7) ◽  
pp. S183-S184
Author(s):  
M Bonafede ◽  
S Pohlman ◽  
E Riehle ◽  
N Adolph ◽  
K Troeger
Keyword(s):  
Surgical Treatment ◽  
Uterine Fibroids ◽  
Treatment Patterns ◽  
Newly Diagnosed

scholarly journals Sclerotic adenomyosis: a case report

2018 ◽  
Vol 67 (6) ◽  
pp. 119-123
Author(s):  
Maria I. Yarmolinskaya ◽  
Eduard K. Ailamazyan ◽  
Arutyun F. Arutyunyan ◽  
Andrey K. Dolinskiy ◽  
Sergey N. Gaidukov
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Histological Examination ◽  
Uterine Fibroids ◽  
Case Histories ◽  
Histological Studies ◽  
Histological Characteristics

Four hundred and fifty case histories and results of histological studies of patients who underwent surgical treatment with a diagnosis of adenomyosis and uterine fibroids were retrospectively analyzed. Of all the operated patients, the sclerotic type of adenomyosis was detected in three cases according to the histological examination, which was 0.67%. The retrospective analysis allowed us to reveal the clinical, echographic, and histological characteristics of the sclerotic type of adenomyosis in these patients.

scholarly journals Predictors of genitourinary syndrome in women of elderly reproductive age after hysterectomy

2021 ◽  
pp. 10-13
Author(s):  
Olha Proshchenko ◽  
Iryna Ventskivska ◽  
Natalia Kamuz ◽  
Svitlana Markitanyuk
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Pelvic Floor ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Rehabilitation Program ◽  
Reproductive Age ◽  
Life Assessment ◽  
Floor Failure ◽  
Genitourinary Syndrome

The article presents an analytical assessment of risk factors for distant postoperative urogenital disorders in women of older reproductive age after radical surgical treatment for uterine fibroids. The aim of the study was to optimize the diagnostic algorithm of genitourinary syndrome in women of older reproductive age after hysterectomy for uterine fibroids. Materials and methods – 80 women aged 40 to 50 years were examined: 40 patients after vaginal and laparoscopically assisted vaginal hysterectomy, 40 patients with abdominal hysterectomy, control – 30 relatively healthy women with asymptomatic fibroids. The examination was performed at the stage of preoperative observation and for 3 years after surgery. Research methods: data on the assessment of pelvic floor and urogenital dysfunction using a standardized POP-Q system, physical examination, the ICS classification was used to assess the severity of urinary incontinence; quality of life assessment using the MOS SF-36 questionnaire; standard methods of variation statistics. Research results and their discussion. The most important risk factors for genitourinary syndrome have been identified. These included obstetric and gynecological history (birth of large fetuses, episiotomies, birth trauma, high birth parity, ovarian surgery, the use of gonadotropin-releasing hormone agonists), chronic diseases accompanied by increased intramuscularly; the presence of stigmas of undifferentiated connective tissue dysplasia; clinical manifestations of pelvic floor failure and functional disorders of the urethral sphincter. Conclusions. In the case of surgical treatment of uterine fibroids, it is advisable to take into account not only the presence of vaginal prolapse and initial dysuric manifestations, but also their predictors in the preoperative stage of the examination, as this may affect the choice of method and access in the case of surgical treatment of uterine fibroids. rehabilitation program and will obtain the expected effect of surgical recovery.

scholarly journals Urogenital disorders in women of reproductive age after radical surgeries about uterine myoma – optimization of diagnostic algorithm

2020 ◽  
Vol 5 ◽  
pp. 29-32
Author(s):  
O. M. Proshchenko
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Pelvic Floor ◽  
Surgical Techniques ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Social Significance ◽  
Women Of Reproductive Age ◽  
Floor Failure

The article presents an assessment and analysis of the most important medical and social risk factors for long-term postoperative urogenital disorders in women of reproductive age after radical surgical treatment for uterine fibroids. Radical operations for uterine fibroids cause an increase in the proportion of urogenital disorders, the clinical manifestations of which have a negative impact on the physical, psycho-emotional form and social significance of women in society. A survey of 80 women aged 40 to 50 years, the main group included 40 patients who underwent vaginal hysterectomy, the comparison group consisted of 40 patients with hysterectomy performed by abdominal access. Data on the assessment of pelvic floor condition and urogenital dysfunction using a standardized POP-Q system, both at the stage of preoperative observation and for 3 and 5 years after surgery. Сonducted surveys, filling diaries of pain, urination, physical examination and bimanual examination, determination of the pH of the vaginal contents, colposcopy, evaluated the index of the vaginal condition, the state of the microbiota of the mucous membranes, a comprehensive urodynamic examination, cystometry, ultrasound examination of the pelvic organs and assessment of ovarian structure.The most important risk factors are identified, which would allow to form groups of patients that require individualized approaches in the choice of surgical techniques and rehabilitation program. These included obstetric and gynecological history (birth of large fetuses, episiotomies, birth injuries, high birth parity); ovarian surgery, the use of gonadotropin-releasing hormone agonists. chronic diseases of the respiratory system and gastrointestinal tract, accompanied by increased intra-abdominal pressure; the presence of stigmas of undifferentiated connective tissue dysplasia; clinical manifestations of pelvic floor failure and functional disorders of the urethral sphincter. When choosing a method and access in case of surgical treatment for uterine fibroids, it is advisable to take into account the presence of pelvic prolapse and initial dysuric manifestations in women, the functional state of the sphincter apparatus and urethral hypermobility, obstetric and gynecological pathology and previous surgery on the organs of the uterus. the patient, her awareness of possible complications, the surgeon’s experience and his choice of surgical techniques.

scholarly journals Comparative Plasma Levels of Vitamin D in Women with or without Uterine Fibriods in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

2021 ◽  
pp. 1-5
Author(s):  
Abidoye Gbadegesin ◽  
Keyword(s):  
Vitamin D ◽  
Plasma Levels ◽  
Uterine Fibroids ◽  
Serum Levels ◽  
Reproductive Age ◽  
University Teaching ◽  
State University ◽  
Reproductive Age Women ◽  
25 Hydroxy Vitamin D ◽  
Control Study

Background: Fibroids are commonest benign tumour of the uterus in reproductive age women. Surgical treatment has been the mainstay of treatment for symptomatic fibroids. Recently, hypovitamin D has been associated with fibroid. The aim of the study was to compare the level of vitamin D in women with fibroids and women without fibroids. Aim: To determine and compare plasma levels of Vitamin D in women with uterine fibroids and those without uterine fibroids Method: An institution based case control study comprising of 274 women. It compared the serum levels of 25 hydroxy vitamin D in 137 women with uterine fibroids and 137 women without uterine fibroids as controls. Result: The level of vitamin D in the women with and without uterine fibroids were {13.5ng /ml, (IQR 3.8 – 22.1)} and {52.1 ng/ml, (IQR 30.6 – 75.0)} (P = < 0.001) respectively. Conclusion: The plasma level of 25-Hydoxy vitamin D was significantly lower in women with uterine fibroids and higher in women without fibroids. Subsequently, prompt detection of vitamin D deficiency by screening with effective treatment may reduce the incidence of fibroids and its sequelae in these group of women.

scholarly journals The associations between serum vitamin D, calcium and uterine fibroids in Chinese women: a case-controlled study

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092349
Author(s):  
Saisai Li ◽  
Beilei Chen ◽  
Bo Sheng ◽  
Jing Wang ◽  
Xueqiong Zhu
Keyword(s):  
Vitamin D ◽  
Uterine Fibroids ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Reproductive Age ◽  
Controlled Study ◽  
Female Population ◽  
Serum 25Ohd ◽  
Female Patients ◽  
Serum Vitamin D

Objective To investigate the associations between serum vitamin D, calcium and uterine fibroids in a Chinese female population. Methods In this case-control study, adult female patients with fibroids (cases) were compared with females without fibroids (controls) in terms of serum 25-hydroxyvitamin D (25OHD) and calcium levels. Results Out of 546 total participants (mean age, 41.68 ± 5.99 years; 279 with fibroids and 267 without fibroids), only 232 had serum 25OHD levels above the sufficient threshold (>20 ng/ml). In addition, females with fibroids had lower serum 25OHD levels versus those without fibroids. The prevalence of fibroids in females with deficient (<12 ng/ml) and insufficient (12–20 ng/ml) 25OHD levels were significantly higher than in females with sufficient (>20 ng/ml) 25OHD levels. Serum calcium levels were within normal range in both groups. Conclusion Hypovitaminosis D was highly prevalent among a population of Chinese females of reproductive-age, and serum 25OHD levels were lower in female patients with fibroids.

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