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.

scholarly journals Uterine submucosal leiomyomas: modern diagnosis and miniinvasive surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 88-93
Author(s):  
Oana Denisa Balalau ◽  
◽  
Mihai-George Loghin ◽  
Sabin Vasilache ◽  
Octavian Gabriel Olaru ◽  
...  
Keyword(s):  
Recovery Time ◽  
Uterine Fibroids ◽  
Therapeutic Decision ◽  
Common Complication ◽  
Hysteroscopic Myomectomy ◽  
Abdominal Myomectomy ◽  
Pelvic Tumors ◽  
Submucosal Fibroids ◽  
Miniinvasive Surgery ◽  
Vaginal Myomectomy

Uterine leiomyomatosis is one of the most common benign pelvic tumors diagnosed in women aged 25-44 years. Clinically, it is manifested by vaginal bleeding, pelvic pain, infertility, digestive and urinary symptoms. The diagnosis of uterine fibroids requires careful clinical and paraclinical evaluation. Based on these data, the therapeutic decision is conducted in most cases. The treatment of uterine leiomyomatosis involves several procedures, such as: total abdominal hystectomy, total vaginal hystectomy, abdominal myomectomy, vaginal, laparoscopic or hysteroscopic myomectomy. Hysteroscopic myomectomy is currently the preferred procedure for submucosal fibroids. It has multiple advantages: shorter recovery time, reduced pain related to movements, shorter duration procedure and fewer risks. The procedure has few contraindications. The most common complication is recurrence. The treatment of choice for prolapsed pedunculated submucous leiomyoma is vaginal myomectomy. As described, the procedure has multiple advantages and generally has a low recurrence rate.

Prevalence of Depression and Anxiety in Parkinson Disease and Impact on Quality of Life: A Community-Based Study in Spain

2019 ◽  
Vol 33 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Fany Chuquilín-Arista ◽  
Tania Álvarez-Avellón ◽  
Manuel Menéndez-González
Keyword(s):  
Quality Of Life ◽  
Parkinson Disease ◽  
Negative Impact ◽  
Anxiety And Depression ◽  
Sociodemographic Characteristics ◽  
Depression And Anxiety ◽  
Community Based ◽  
Increased Risk ◽  
Prevalence Of Depression

Background: Identifying neuropsychiatric disorders is essential for prompt treatment to reduce morbidity. Among these disorders, anxiety and depression have been frequently associated with Parkinson disease (PD), particularly among elderly population. Objective: The objective of this study is to determine the prevalence of anxiety and depression in a series of community-based PD cases in Spain, their relationship with different clinical and sociodemographic characteristics, and quality of life. Methods: This is an observational, descriptive, survey-based study with 95 community-based patients with PD diagnosis at different disease stages. Anxiety and depression were assessed using the State-Trait Anxiety Inventory and the Beck Depression Inventory II, respectively. Quality of life was assessed using the Parkinson’s Disease Questionnaire 39. Results: The prevalence of depression and anxiety was 32.63% and 68.42%, respectively. Concomitant depression and anxiety were observed in 31.58% of patients. Patients with longer than 10 years’ PD duration had an increased risk of depression. We found a relationship between the presence of anxiety, depression, and the patient’s quality of life. Conclusions: Depression is present in one-third and anxiety in two-thirds of PD cases in community settings in Spain. Depression and anxiety have a very negative impact on quality of life in PD. Both anxiety and depression are independent from sociodemographic characteristics, patient’s comorbidities, or antiparkinsonian treatments; presenting as intrinsic symptoms in PD.

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 Improvement of surgical treatment in diffuze adenomyosis (a review)

2020 ◽  
pp. 254-259
Author(s):  
A. A. Gorpenko ◽  
V. D. Chuprinin ◽  
N. A. Buralkin ◽  
A. S. Safronova
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Surgical Techniques ◽  
Abnormal Uterine Bleeding ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Management Guideline ◽  
Scientific Databases ◽  
Universal Approach

Introduction. Adenomyosis has a significantly negative impact on women’s quality of life, causing abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain and low quality of life. There are no single theory of pathogenesis, unique prognosis and diagnostic markers for adenomyosis. The definitive treatment for adenomyosis is hysterectomy but is not appropriate for patients who wish to preserve their fertility. In this article presents data about etiology, classification, pathogenesis, clinical manifestation and surgical techniques for the treatment of adenomyosis published in medical–scientific databases.Materials and methods. The review includes data from foreign and Russian articles published in the Pubmed journals on this topic.Results. There are a lot of surgical approaches for adenomyosis; however, there is no any universal approach and management guideline for these patients.Conclusion. Adenomyosis – if multifactorial disease. There is no single pathogenesis theory. The clinical picture of adenomyosis varies from asymptomatic to severe pain. The management of adenomyosis is complex and should guide personally for each patient. All techniques and options should be considered and discussed with the patient.

scholarly journals Nutrition in Gynecological Diseases: Current Perspectives

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1178
Author(s):  
Michał Ciebiera ◽  
Sahar Esfandyari ◽  
Hiba Siblini ◽  
Lillian Prince ◽  
Hoda Elkafas ◽  
...  
Keyword(s):  
Health Management ◽  
Negative Impact ◽  
Malignant Tumors ◽  
Polycystic Ovary ◽  
Uterine Fibroids ◽  
Nutrient Deficiency ◽  
Gynecological Diseases ◽  
Beneficial Impact ◽  
Bibliographic Search

Diet and nutrition are fundamental in maintaining the general health of populations, including women’s health. Health status can be affected by nutrient deficiency and vice versa. Gene–nutrient interactions are important contributors to health management and disease prevention. Nutrition can alter gene expression, as well as the susceptibility to diseases, including cancer, through several mechanisms. Gynecological diseases in general are diseases involving the female reproductive system and include benign and malignant tumors, infections, and endocrine diseases. Benign diseases such as uterine fibroids and endometriosis are common, with a negative impact on women’s quality of life, while malignant tumors are among the most common cause of death in the recent years. In this comprehensive review article, a bibliographic search was performed for retrieving information about nutrients and how their deficiencies can be associated with gynecological diseases, namely polycystic ovary syndrome, infertility, uterine fibroids, endometriosis, dysmenorrhea, and infections, as well as cervical, endometrial, and ovarian cancers. Moreover, we discussed the potential beneficial impact of promising natural compounds and dietary supplements on alleviating these significant diseases.

Treatment of Uterine Pathology

2021 ◽  
pp. 305-320
Author(s):  
Dimitrios Tsolakidis ◽  
Maria Lantzanaki
Keyword(s):  
Chronic Pelvic Pain ◽  
Negative Impact ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Uterine Bleeding ◽  
Trophoblastic Disease ◽  
Life Threatening

Hysterectomy is the most common gynecological operation after cesarean section. The majority of hysterectomies are performed for the treatment of benign diseases, which, although not life-threatening, may have a negative impact on the quality of patient's life. Abnormal uterine bleeding is the most common indication for hysterectomy in premenopausal women and is usually a result of myomas and adenomyosis. Another indication is chronic pelvic pain that is usually caused by endometriosis and/or adenomyosis. A simple hysterectomy can be the treatment of choice in early stages of endometrial, cervical cancer, sarcomas, or gestational trophoblastic disease. Laparoscopic hysterectomy is superior to laparotomy when a vaginal hysterectomy is contraindicated.

scholarly journals Predicting the Fibroid-Migratory Impact of UAE: Role of Pre-embolization MRI Characteristics

2019 ◽  
Vol 43 (3) ◽  
pp. 453-458
Author(s):  
Leto Mailli ◽  
Eric Y. Auyoung ◽  
Salvatore A. Angileri ◽  
Seyed Ameli-Renani ◽  
Lakshmi Ratnam ◽  
...  
Keyword(s):  
Uterine Fibroids ◽  
High Likelihood ◽  
Tertiary Centre ◽  
Shortest Distance ◽  
Endometrial Cavity ◽  
Submucosal Fibroids ◽  
Potential Factors ◽  
Mri Characteristics ◽  
Intramural Fibroids

Abstract Aim To investigate potential factors on MR imaging that could be used to predict migration of uterine fibroids post-UAE. Methods and Materials We retrospectively reviewed patients referred for UAE having pre-procedural and 6 months post-procedural MRI, at a tertiary centre, over a 1-year period. Pre- and post-UAE images were reviewed in 64 women by two radiologists to identify the sub-type, dimensions, and infarction rate of each dominant fibroid. The shortest distance between the fibroid and the endometrial wall was measured to determine intramural fibroid movement. Paired sample T tests and two-sample T tests were used to compare between pre- and post-embolization variations and between migrated and non-migrated intramural fibroids, respectively. After preliminary results suggested potential predictors of intramural fibroids migration, we tested our findings against the non-dominant intramural fibroids in the same patients. Results Review of images revealed 35 dominant intramural fibroids, of which eight migrated to become submucosal fibroids, while five were either partially or completely expelled. These 13 migrated fibroids had a shorter pre-procedural minimum endometrial distance (range 1–2.4 mm) and greater maximum fibroid diameter (range 5.1–18.1 cm), when compared to non-migrating fibroids. On image reassessment, the migrated non-dominant intramural fibroids had a minimum endometrial distance and maximum fibroid diameter within the same range. Conclusion Intramural fibroids with a minimum endometrial distance less than 2.4 mm and a maximum fibroid diameter greater than 5.1 cm have a high likelihood of migrating towards the endometrial cavity after UAE.

scholarly journals ABNORMAL UTERINE BLEEDING IN ADOLESCENTS: CURRENT STATE OF THE PROBLEM

2020 ◽  
Vol 73 (8) ◽  
pp. 1752-1755
Author(s):  
Iryna O. Tuchkina ◽  
Liudmyla A. Vygivska ◽  
Anastasia A. Novikova
Keyword(s):  
Negative Impact ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
The Body ◽  
Reproductive Age ◽  
Current State ◽  
Literary Sources ◽  
Made In

The aim: To summarize the literature data on abnormal uterine bleeding in adolescents. Materials and methods: This article presents an assessment of 32 literary sources from 2003 to 2018, which raise the issues of etiology and pathogenesis of abnormal uterine bleeding in adolescents. Abnormal uterine bleeding in adolescents (AUBA) is a risk factor for disorders of menstrual and generative function, hormone-related abnormalities in the reproductive age. Despite the progress made in the development of methods for the diagnosis and treatment of AUBA, the criteria for selecting a particular method of diagnosis and therapy have not yet been made sufficiently clear. Conclusions: AUBA is a complex polyetiological disease affecting all parts of the hypothalamic-pituitary-adrenal-ovarian system. It has a negative impact on the girl’s health and quality of life. Abnormal uterine bleeding is a “signal” to the body of an organic or functional disorder. If this feature is ignored, the pathology can progress and lead to severeconsequences. The urgency of the problem of AUBA is further explained by the fact that this disease indicates the presence of serious disorder of the reproductive system, which in the future may be transformed into impaired reproductive function.

scholarly journals Аssessment of osteoporosis and occurrence of vertebral fractures in postmenopausal patients with rheumatoid arthritis treated with small doses of glucocorticoids

2020 ◽  
Vol 12 (3) ◽  
pp. 1-8
Author(s):  
Maja Bojadzioska ◽  
Petar Dejanov ◽  
Irena Kafedziska ◽  
Mimoza Nikolovska-Kotevska ◽  
Andzelika Karadzova-Stojanoska ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vertebral Fractures ◽  
Negative Impact ◽  
Vertebral Fracture Assessment ◽  
Treatment Of Osteoporosis ◽  
Increased Risk ◽  
Small Doses ◽  
Fracture Assessment

Osteoporosis (OP) is a serious extracorporeal manifestation that occurs in patients with rheumatoid arthritis (RA). One of the risk factors is long-term use of glucocorticoids (GC). Osteoporosis together with the increased risk of vertebral (VF) and non-vertebral fractures (non-VF) in particular has a negative impact on quality of life in patients with rheumatoid arthritis. The aim of the study was to detect the occurrence of OP and VF in postmenopausal patients with RA and their association with long-term use of small doses of glucocorticoids. Material and methods: A total of 46 patients were analyzed. All respondents underwent imaging for osteoporosis evaluation with a DXA scanner (Lunar iDXA, GE) and VF  with incorporated Vertebral Fracture Assessment (VFA). Results: The values of bone mineral densities (BMD) were significantly smaller in the group that received glucocorticoids. According to VFA, 37,0% of patients were registered to have a fracture of middle degree, a mild fracture was registered in 19.6% of patients, and severe fractures were registered in 3 patients (6.5%). Conclusion: In postmenopausal patients with RA receiving GC therapy, a more common occurrence of osteoporosis and vertebral fractures was reported compared with the remaining group of RA patients. All patients with RA in menopause need to be screened for timely detection and treatment of osteoporosis and prevention of its complications.

RETROSPECTIVE STUDY OF UTERINE FIBROID PATIENTS AT TERTIARY LEVEL HOSPITAL

2021 ◽  
pp. 33-35
Author(s):  
Gitika Sharma ◽  
Ranjana Atal ◽  
Vidisha Payal ◽  
Samta Bali Rathore
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Tertiary Care ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Abdominal Distension ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Benign Tumours

Background: Fibroids are the most common benign tumours of the uterus. They can be asymptomatic or might present with different symptoms varied from heavy menstrual bleeding, dyspareunia, abdominal distension, or pressure-related bladder symptoms etc. Present study was done with the aim to assess the clinical features of uterine broids.Material &methods:It was a retrospective Hospital based study conducted over a period of six months in which 131 women who attended Gynecology OPD of a tertiary care teaching hospital in Rajasthan from January to June 2019 with complaints of menstrual disorders with anemia or abdomino-pelvic mass with pain and feeling heaviness in the abdomen were included.Results: Out of 131 women, 37 (28.2%) women presented to Gynecology OPD with abdomino-pelvic mass without any menstrual abnormality while 94 (71.8%) women were symptomatic. 53.4% women presented with Heavy menstrual bleeding while Dysmenorrhea (n=65; 49.6%), Fullness/heaviness in abdomen (n=61; 46.6%), Irregular period (n=57; 43.5%), Prolonged duration of menstrual bleeding (n=42; 32.0%), Constipation/bloating/diarrhoea (n=41; 31.3%) and non-menstrual pelvic pain/cramping (n=39; 29.8%) were other symptoms seen in women with broids. Conclusion : Uterine broids cause abnormal uterine bleeding and other symptoms which have negative impact on women's quality of life, affecting their sexual, social and professional life. Early diagnosis and treatment reduces morbidity and improves quality of life.

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