uterine fibroids
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2022 ◽  
Vol 49 (1) ◽  
pp. 1
Author(s):  
Radmila Sparić ◽  
Mladen Andjić ◽  
Lazar Nejković ◽  
Jelena Štulić ◽  
Aleksandar Dmitrović ◽  
...  
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Cureus ◽  
2022 ◽  
Author(s):  
Anadi S Tasa ◽  
Sandeep Dey ◽  
Suren Dutta ◽  
Dhrubajit Gogoi ◽  
Bikash Bora

2022 ◽  
Vol 12 (2) ◽  
pp. 563
Author(s):  
Matin Torabinia ◽  
Alexandre Caprio ◽  
Tamatha B. Fenster ◽  
Bobak Mosadegh

Uterine fibroids represent the highest prevalence of benign tumors in women, with reports ranging from 4.5% to 68.6%, with a significant bias towards African American women. For uterine fibroids, a significant decision is determining whether fibroids can be successfully removed using minimally invasive (MI) techniques or their removal requires open surgery. Currently, the standard-of-care for intra-procedural visualization for myomectomies is ultrasound, which has low image quality and requires a specially trained assistant. Currently, the state-of-the-art is to obtain a pre-procedural MRI scan of the patient, which can be used for diagnosis and pre-procedural planning. Although proven incredibly useful pre-procedurally, MRI scans are not often used intra-procedurally due to the inconvenient visualization as 2D slices, which are seen on 2D monitors that do not intuitively convey the depth or orientation of the fibroids, as needed to effectively perform myomectomies. To address this limitation, herein, we present the use of a mixed reality headset (i.e., Microsoft HoloLens 2), as a tool for intra-procedural image-guidance during a mock myomectomy of an ex vivo animal uterus. In this work, we created a patient-specific holographic rendering by performing image segmentation of an MRI scan of a custom-made uterine fibroid animal model. A physician qualitatively assessed the usefulness of the renderings for fibroid localization, as compared to the same visualization on a 2D monitor. In conclusion, the use of mixed reality as an intra-procedural image guidance tool for myomectomies was perceived as a better visualization technique that could lead to improvements in MI approaches and make them accessible to patients from lower socioeconomic populations.


Author(s):  
Raj Das ◽  
Anita Wale ◽  
Seyed Ameli Renani ◽  
Lakshmi Ratnam ◽  
Leto Mailli ◽  
...  

Abstract Purpose The PURE study is a randomised controlled trial (RCT) comparing the clinical and MRI outcomes of patients treated with non-spherical polyvinyl alcohol, ns-PVA (Contour PVA–Boston Scientific–355–500 & 500–700 microns) versus calibrated hydrogel microspheres (Embozene–Varian Inc–700 & 900 microns) for symptomatic uterine fibroids. Materials and Methods Prospective, ethically approved non-sponsored RCT in 84 patients in a single UK tertiary IR unit, ISRCTN registry trial number ISRCTN18191539 in 2013 and 2014. All patients with symptomatic fibroid disease were eligible. UAE followed a standardised protocol with UFS-QOL and contrast-enhanced MRI before and 6 months post UAE. Outcome measures included: (1) Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QOL). (2) Percentage total and dominant fibroid infarction. (3) Uterine and dominant fibroid volume reduction. (4) Volume of embolics. Results Sixty-three patients completed the QOL follow-up (33 ns-PVA vs 30 Embozenes), the groups were equivalent at baseline. Patients were followed up for 6 months following UAE. There was no significant difference in symptom scores or HR-QOL between ns-PVA and Embozenes, p = 0.67 and 0.21, respectively. 92.7% of patients treated with ns-PVA achieved > 90% dominant fibroid infarction versus 61.8% treated with Embozenes (p = 0.0016). 66% of patients treated with ns = PVA achieved > 90% total fibroid percentage infarction compared with 35% in the Embozene group (p = 0.011). The mean vials/syringes used were 5.2 with Embozenes versus 4.1 using PVA (p = 0.08). Conclusion The PURE study informs IRs regarding the efficacy of embolic agents in UAE, with superior fibroid infarction on MRI using ns-PVA versus Embozenes however no significant difference in clinical outcomes at 6 months after UAE.


Physiology ◽  
2022 ◽  
Vol 37 (1) ◽  
pp. 16-27
Author(s):  
Elizabeth A. Stewart ◽  
Romana A. Nowak

Uterine fibroids (leiomyomas) are present in >75% of women and can cause serious morbidity. They are by far the leading cause of hysterectomy. Fibroids are a complex mixture of cells that include fibroblasts and smooth muscle cells. Rich in extracellular matrix, they typically arise through somatic mutations, most commonly MED12. Their lack of growth inhibition and their ability to have facets of malignancy yet be histologically and biologically benign provide opportunities to explore basic processes. To date, the mechanisms responsible for growth and development of leiomyomas are an enigma. This review provides an overview of current understanding and future directions for clinical and basic research of fibroids.


Author(s):  
Vilas Namdev Kurude ◽  
Sneha Shekharreddy Mutyapwar

Background: Uterine fibroids (leiomyomas) are most common tumours of the uterine smooth muscles, appear to increase in incidence with age during reproductive years, with a peak in incidence between 35 to 40 years. Signs and symptoms of uterine fibroids include heavy or prolonged menstrual bleeding, pain and pregnancy complications. Current management strategies mainly involve surgical interventions, but choice of treatment is guided by patient’s age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy.Methods: It is the prospective observational study conducted in inpatients of department of OBGY at tertiary care hospital, admitted during the period of June 2019 to May 2021. Outcome measured in terms of relief of symptoms, decrease in size of fibroid, requiring subsequent surgery, quality of life, blood transfusion requirements, length of stay in hospital, successful pregnanciesResults: Of patients treated with ulipristal, 78.57% had improved quality of life, in patients treated with leuprolide, 57.14% showed improved quality of life, with mifepristone 80% patients showed improved quality of life and with LNG 100% patients responded to it. All patients treated surgically, showed relief of symptoms.Conclusions: Medical line of management is best for patients in younger age group, small size fibroid, desire for future fertility. Uterus sparing option like myomectomy is done in patients not responding to medical line of management and desire for future fertility. Hysterectomy is definitive line of management for patients with fibroid uterus.


2021 ◽  
Vol 51 (3) ◽  
pp. 113-116
Author(s):  
V. I. Krasnopolsky ◽  
S. N. Buianova

Endometriosis as a gynecological disease is becoming a problem of the century, occupying the third place in the structure of gynecological pathology after inflammatory diseases and uterine fibroids. Insufficient effectiveness of treatment, disability and neurotization of women suffering from genital endometriosis, infertility as an important family and state problem. - a short list of troubles. caused by this disease.


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