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International Journal of Environmental... Jan 2021Uterine myomas or fibroids are the most common benign female tumors of the reproductive organs, associated with significant morbidity and quality of life impairment.... (Review)
Review
Uterine myomas or fibroids are the most common benign female tumors of the reproductive organs, associated with significant morbidity and quality of life impairment. Several epidemiological risk factors for their occurrence have been identified so far, including nutrition and dietary habits. In this investigation, authors reviewed, as a narrative review, the data about diet and uterine myoma development in order to homogenize the current data. A PubMed search was conducted for the years 1990-2020, using a combination of keywords of interest for the selected topic. The authors searched the databases, selecting the randomized clinical studies, the observational studies, and the basic (experimental), clinical, and epidemiological researches. Once they collected the articles, they analyzed them according to the number of citations of each article, starting from the most cited to the least cited articles. Subsequently, authors collected the data of each article and inserted them in the various research paragraphs, summarizing the data collected. In this way, they crossed the available data regarding the association between nutrition habits and dietary components and myoma onset and growth. Many nutrients and dietary habits are associated with myoma development risk. These factors include low intakes of fruit, vegetables, and vitamin D, as well as pollutants in food. Despite the available data on the influence of some foods on the development of fibroids, further research is mandatory to understand all the nutrition risk factors which contribute to myoma growth and how exactly these risk factors influence myoma pathogenesis.
Topics: Diet; Female; Fruit; Humans; Leiomyoma; Quality of Life; Uterine Neoplasms; Vegetables
PubMed: 33504114
DOI: 10.3390/ijerph18031066 -
Fertility and Sterility Mar 2021Congenital and acquired uterine anomalies are associated with recurrent pregnancy loss (RPL). Relevant congenital Müllerian tract anomalies include unicornuate,... (Review)
Review
Congenital and acquired uterine anomalies are associated with recurrent pregnancy loss (RPL). Relevant congenital Müllerian tract anomalies include unicornuate, bicornuate septate, and arcuate uterus. Recurrent pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as, notably, intrauterine adhesions, polyps, and submucosal myomas. Initial evaluation of women with RPLs should include an assessment of the uterine anatomy. Even if proof of efficacy of surgical management of certain uterine anomalies is often lacking for managing RPLs, surgery should be encouraged in certain circumstances for improving subsequent pregnancy outcome. Uterine anomalies such as uterine septa, endometrial polyps, intrauterine adhesions, and submucosal myomas are the primary surgical indications for managing RPLs.
Topics: Abortion, Habitual; Female; Humans; Hysteroscopy; Pregnancy; Urogenital Abnormalities; Uterus
PubMed: 33712099
DOI: 10.1016/j.fertnstert.2020.12.003 -
Human Reproduction Update Nov 2016Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses,... (Review)
Review
Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications.Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid 'radical' surgery such as hysterectomy. The management of uterine fibroids also depends on the number, size and location of the fibroids. Other surgical and non-surgical approaches include myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization and interventions performed under radiologic or ultrasound guidance to induce thermal ablation of the uterine fibroids.There are only a few randomized trials comparing various therapies for fibroids. Further investigations are required as there is a lack of concrete evidence of effectiveness and areas of uncertainty surrounding correct management according to symptoms. The economic impact of uterine fibroid management is significant and it is imperative that new treatments be developed to provide alternatives to surgical intervention.There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids due to the use of selective progesterone receptor modulators (SPRMs) such as ulipristal acetate (UPA). The efficacy of long-term intermittent use of UPA was recently demonstrated by randomized controlled studies.The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. These options now exist, with SPRMs which are proven to treat fibroid symptoms effectively. Gynecologists now have new tools in their armamentarium, opening up novel strategies for the management of uterine fibroids.
Topics: Contraceptive Agents; Female; Humans; Hysterectomy; Leiomyoma; Magnetic Resonance Imaging; Norpregnadienes; Pelvic Pain; Progesterone; Randomized Controlled Trials as Topic; Risk Factors; Uterine Artery; Uterine Neoplasms
PubMed: 27466209
DOI: 10.1093/humupd/dmw023 -
Przeglad Menopauzalny = Menopause Review Dec 2017A new International Federation of Gynecology and Obstetrics classification for myomas was recently described. Type 0, 1 and 2 are the submucosal fibroids. Submucous... (Review)
Review
A new International Federation of Gynecology and Obstetrics classification for myomas was recently described. Type 0, 1 and 2 are the submucosal fibroids. Submucous myomas represent one of the main indications for operative hysteroscopy. Hysteroscopic resection of submucous fibroids should be a simple, well-tolerated procedure and ideally finished in a single surgical step. Hysteroscopic myomectomy is an effective procedure. Fertility outcome and menorrhagia are improved by this procedure. However, for menorrhagia, a recurrence can occur mainly during the first year following the surgery. For bleeding outcome, a success rate from 70 to 99% has been reported by different studies. The success rate seems to decline as the follow- up period increases. For fertility outcome, submucosal fibroids have negative impact on pregnancy rates. The size of the fibroids plays a crucial role in completing the hysteroscopic myomectomy in a single step. A diameter greater than 3 cm in type 2 myomas results in a higher risk of a multiple procedure.
PubMed: 29483854
DOI: 10.5114/pm.2017.72757 -
Ugeskrift For Laeger Sep 2021Parasitic myomas are fibromyomas without anatomical relation to the uterus. It is a rare condition mostly described after laparoscopic fibroid morcellation. This is a...
Parasitic myomas are fibromyomas without anatomical relation to the uterus. It is a rare condition mostly described after laparoscopic fibroid morcellation. This is a case report of a patient with a symptomatic abdominal mass eight years after total abdominal hysterectomy. A parasitic myoma was found in relation to coecum and removed laparoscopically. The condition should be considered in symptomatic women with previous fibroid surgery.
Topics: Female; Fibroma; Humans; Hysterectomy; Laparoscopy; Leiomyoma; Morcellation; Uterine Neoplasms
PubMed: 34596516
DOI: No ID Found -
BioMed Research International 2018Myomectomy aims to preserve fertility, treat abnormal uterine bleeding, and alleviate pain. It should cause minimal damage to the endometrium, while being tolerable and... (Review)
Review
Myomectomy aims to preserve fertility, treat abnormal uterine bleeding, and alleviate pain. It should cause minimal damage to the endometrium, while being tolerable and durable, and reduce the incidence of myoma recurrence and complications including bleeding, hematoma, adhesions, and gravid uterus perforation. Training and experience are crucial to reduce complications. The surgical strategy depends on imaging information on the myomas. The position of the optical and secondary ports will determine the degree of ergonomic surgery performance, time and difficulty of myoma enucleation, and the suturing quality. Appropriate hysterotomy length relative to myoma size can decrease bleeding, coagulation, and suturing times. Bipolar coagulation of large vessels, while avoiding carbonization and myometrium gaps after suturing, may decrease the risk of myometrial hematoma. Quality surgery and the use of antiadhesive barriers may reduce the risk of postoperative adhesions. Slow rotation of the beveled morcellator and good control of the bag could reduce de novo myoma and endometriosis. Low intra-abdominal CO pressure may reduce the risk of benign and malignant cell dissemination. The benefits a patient gains from laparoscopic myomectomy are greater than the complication risks of laparoscopic morcellation. Recent publications on laparoscopic myomectomies demonstrate reduced hospitalization stays, postoperative pain, blood loss, and recovery compared to open surgery.
Topics: Humans; Laparoscopy; Length of Stay; Myoma; Postoperative Complications; Risk; Uterine Myomectomy
PubMed: 29693017
DOI: 10.1155/2018/8250952 -
International Journal of Fertility &... 2016Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our... (Review)
Review
Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our investigation, we have reviewed the epidemiological data related to the development of myomas in order to homogenize the current data. Therefore, a MEDLINE and PubMed search, for the years 1990-2013, was conducted using a combination of keywords, such as "myoma," "leiomyoma," "fibroids," "myomectomy," "lifestyle," "cigarette," "alcohol," "vitamins," "diet," and "hysterectomy". Randomized controlled studies were selected based upon the authors' estimation. Peer-reviewed articles examining myomas were sorted by their relevance and included in this research. Additional articles were also identified from the references of the retrieved papers and included according to authors' estimation. Many epidemiologic factors are linked to the development of myomas; however, many are not yet fully understood. These factors include age, race, heritage, reproductive factors, sex hormones, obesity, lifestyle (diet, caffeine and alcohol consumption, smoking, physical activity and stress), environmental and other influences, such as hypertension and infection. Some of the epidemiological data is conflicting. Thus, more research is needed to understand all the risk factors that contribute to myoma formation and how they exactly influence their onset and growth.
PubMed: 26985330
DOI: 10.22074/ijfs.2015.4599 -
PloS One 2017The published data about alcohol consumption and uterine myoma are scanty and controversial: some studies found positive association whereas other studies showed no... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The published data about alcohol consumption and uterine myoma are scanty and controversial: some studies found positive association whereas other studies showed no association.
OBJECTIVES
To conduct a systematic review and meta-analysis to determine whether alcohol is a risk factor for myoma.
SEARCH STRATEGY
A MEDLINE/EMBASE search was carried out, supplemented by manual searches of bibliographies of the selected studies.
SELECTION CRITERIA
Articles published as full-length papers in English. In the review we included all identified studies. Otherwise, the inclusion criteria for studies included in the meta-analysis were: a) case-control or cohort studies, reporting original data; b) studies reporting original data on the association between alcohol consumption and myoma; c) diagnosis of myoma was ultrasound or histological confirmed and/or clinically based.
DATA COLLECTION AND ANALYSIS
A total of 6 studies were identified for the review and 5 studies were included in the meta-analysis. The primary outcome was the incidence of uterine myoma in ever versus never alcohol drinkers and when data were available, we also analyzed categories of alcohol intake. We assessed the outcomes in the overall population and then we performed a subgroup analysis according to study design. Pooled estimates of the odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects models.
MAIN RESULTS
The summary OR (95%CI) of myoma forever versus never alcohol intake was 1.12 (0.94-1.34) with significant heterogeneity. The summary OR for current versus never drinking was 1.33 (1.01-1.76) with no heterogeneity.
CONCLUSIONS
Ever alcohol consumption is not associated with myoma risk. Based on the data of two studies, current alcohol drinkers had a slightly borderline increased risk of diagnosis of myoma. In consideration of the very limited number of studies and the suggestion of a potential increased risk among current drinkers, further studies are required.
Topics: Adult; Alcohol Drinking; Female; Humans; Middle Aged; Myoma; Odds Ratio; Risk Factors; Uterine Neoplasms; Young Adult
PubMed: 29176884
DOI: 10.1371/journal.pone.0188355 -
The Pan African Medical Journal 2019The association of myoma and pregnancy is becoming more frequent due to the increasing age of first pregnancy. It may affect the outcome of fertility, pregnancy, labor...
The association of myoma and pregnancy is becoming more frequent due to the increasing age of first pregnancy. It may affect the outcome of fertility, pregnancy, labor and peripartum course. A 37 years old patient was referred to our unit for discovering uterine leiomyoma at 37 weeks of pregnancy. Ultrasound screening showed a praevia isthmic leiomyoma measuring 16cm. A caesarean delivery was scheduled and a large interstitial isthmic uterine myoma measuring 25cm was found. Hysterectomy was corporeal. The post-operative and puerperium course was normal.
Topics: Adult; Cesarean Section; Female; Humans; Hysterectomy; Leiomyoma; Pregnancy; Pregnancy Complications, Neoplastic; Ultrasonography, Prenatal; Uterine Neoplasms
PubMed: 31692727
DOI: 10.11604/pamj.2019.33.216.14898 -
Iatrogenic parasitic myoma and iatrogenic adenomyoma after laparoscopic morcellation: A mini-review.Journal of Advanced Research Nov 2019Laparoscopy is widely recognized as a procedure of choice for gynaecological surgery. Myomectomy and hysterectomy are the most frequently performed surgical procedures... (Review)
Review
Laparoscopy is widely recognized as a procedure of choice for gynaecological surgery. Myomectomy and hysterectomy are the most frequently performed surgical procedures in gynaecology. A morcellator is often used in myomectomies or subtotal hysterectomies, but morcellation may cause rare complications, such as parasitic iatrogenic myoma or adenomyoma. To improve patient counselling, proper risk estimation as well as risk factor identification should be acknowledged. This article aimed to review the literature on parasitic myoma and adenomyoma and to compare these diseases in terms of clinical, surgical, and prognostic factors. All published literature (case series and case reports) on iatrogenic myoma and adenomyoma was reviewed using PubMed/MEDLINE and ScienceDirect resources. Despite both conditions having an iatrogenic origin, iatrogenic parasitic myoma and adenomyoma are two different entities in terms of clinical manifestations as well as intraoperative particularities, with a common point: iatrogenic complication. A possible solution to avoid these iatrogenic complications is by using in-bag morcellation or switching to another surgical procedure (e.g., a vaginal or abdominal approach). It is concluded that parasitic myoma and iatrogenic adenomyoma are two different iatrogenic morcellator-related complications. In patients with a history of uterus or myoma morcellation who report pelvic symptoms, iatrogenic parasitic myoma or adenomyoma should be considered in the differential diagnosis.
PubMed: 31080671
DOI: 10.1016/j.jare.2019.04.004