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Obstetrics and Gynecology Clinics of... Dec 2023Uterine fibroids significantly impact women's reproductive health, influencing fertility potential and pregnancy outcomes. Their growth, often facilitated by hormonal... (Review)
Review
Uterine fibroids significantly impact women's reproductive health, influencing fertility potential and pregnancy outcomes. Their growth, often facilitated by hormonal influences like estrogen and progesterone, can cause considerable disruptions in the uterus, leading to symptoms and complications that impact the quality of life and reproductive prospects of women.This article provides an exhaustive discussion of uterine fibroids, including pathophysiology, their impact on endometrial function, receptivity, fertility, and pregnancy outcomes, and the management of infertility in patients with uterine fibroids. It underlines the critical role of uterine fibroids in women's reproductive health, emphasizing the importance of effective diagnosis and treatment to promote fertility and improve pregnancy outcomes.
Topics: Pregnancy; Humans; Female; Uterine Neoplasms; Uterine Myomectomy; Quality of Life; Leiomyoma; Fertility
PubMed: 37914486
DOI: 10.1016/j.ogc.2023.08.006 -
JAMA May 2024
Topics: Female; Humans; Black or African American; Hysterectomy; Leiomyoma; United States; Uterine Neoplasms; White; Middle Aged
PubMed: 38598205
DOI: 10.1001/jama.2024.0447 -
QJM : Monthly Journal of the... Jul 2023
Topics: Humans; Tracheal Neoplasms; Leiomyoma
PubMed: 36944268
DOI: 10.1093/qjmed/hcad044 -
Frontiers in Endocrinology 2023Uterine leiomyoma is the most common benign tumor in females of reproductive age. However, its causes have never been fully understood. The objective of our study was to... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
Uterine leiomyoma is the most common benign tumor in females of reproductive age. However, its causes have never been fully understood. The objective of our study was to analyze the causal association between various factors and uterine leiomyoma using Mendelian randomization (MR).
METHODS
Genetic variables associated with risk factors were obtained from genome-wide association studies. Summary-level statistical data for uterine leiomyoma were obtained from FinnGen and the UK Biobank (UKB) consortium. We used inverse variance weighted, MR-Egger, and weighted median methods in univariate analysis. Multivariable MR analysis was used to identify independent risk factors. A fixed-effect model meta-analysis was used to combine the results of the FinnGen and UKB data.
RESULTS
In the FinnGen data, higher genetically predicted age at natural menopause, systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting insulin were associated with an increased risk of uterine leiomyoma, while higher age at menarche was associated with a reduced risk of uterine leiomyoma. Multivariable MR analysis of SBP and DBP showed that higher DBP might be an independent risk factor of uterine leiomyoma. In the UKB data, the results for age at natural menopause, SBP, DBP, and age at menarche were replicated. The result of the meta-analysis suggested that uterine leiomyoma could also be affected by polycystic ovary syndrome (PCOS), endometriosis, and 2-hour glucose level.
CONCLUSION
Our MR study confirmed that earlier menstrual age, hypertension, obesity, and elevated 2-hour glucose post-challenge were risk factors for uterine leiomyoma, and the causal relationship between smoking and uterine leiomyoma was ruled out. In addition, later age of menopause and endometriosis were found to increase the risk of uterine leiomyoma, while PCOS was found to decrease the risk.
Topics: Female; Humans; Endometriosis; Genome-Wide Association Study; Mendelian Randomization Analysis; Leiomyoma; Polycystic Ovary Syndrome; Glucose
PubMed: 37576957
DOI: 10.3389/fendo.2023.1133260 -
Archivos de Cardiologia de Mexico Sep 2023
Topics: Humans; Leiomyoma; Heart; Heart Neoplasms
PubMed: 37669690
DOI: 10.24875/ACM.22000205 -
Current Opinion in Obstetrics &... Oct 2023Fibroids are benign pelvic masses and constitute the most common gynaecological condition. They create a significant health and social burden to many women because of... (Review)
Review
PURPOSE OF REVIEW
Fibroids are benign pelvic masses and constitute the most common gynaecological condition. They create a significant health and social burden to many women because of heavy menstrual bleeding and fibroid pressure symptoms. Many women will be faced with the dilemma of surgical management to improve their symptoms at some point of their reproductive age. The aim of this article is to identify current surgical management of fibroids describing the technical steps, advantages, disadvantages and risks of each method.
RECENT FINDINGS
The surgical management of fibroids remains challenging, as the overall prevalence, the clinical experience and the patient awareness is increasing because of an upgrade in our sonographic and magnetic resonance diagnostic tools. Unfortunately not every patient is able to benefit from tailor-made surgery that holistically evaluates individual needs including fertility aspirations.
SUMMARY
This article provides the most current synopsis of every available surgical modality for fibroid management. Large prospective multicentre cohort studies are needed to definitely determine the most suitable operation for any individual suffering with fibroids; and perhaps artificial intelligence may offer a valuable tool in the future data analysis.
Topics: Female; Humans; Uterine Neoplasms; Prospective Studies; Artificial Intelligence; Leiomyoma; Menorrhagia
PubMed: 37548229
DOI: 10.1097/GCO.0000000000000903 -
Fertility and Sterility Jul 2024Fibroids are a common pathology and increasingly observed in women seeking medical treatment for infertility. The longer reproductive horizon because of improvements in... (Review)
Review
Fibroids are a common pathology and increasingly observed in women seeking medical treatment for infertility. The longer reproductive horizon because of improvements in medical care and current trend for women to postpone childbearing are making fibroid-related infertility increasingly common. This review aimed to critically analyze the association between uterine fibroids and infertility, mechanisms by which uterine fibroids may impair fertility, and management of myoma-related infertility. The association of fibroids with infertility is a source of controversy. As the focus of this review is infertility, it is crucial to analyze the mechanisms by which fertility may be impaired by the presence of fibroids. Current management strategies involve mainly surgical interventions, including myomectomy by hysteroscopy, laparotomy, or laparoscopy, and nonsurgical approaches, such as uterine artery embolization and focused ultrasound performed under radiologic or echographic guidance. The risks and benefits of each option should be discussed with patients, and several factors need to be considered, including the skills of surgeons and availability of different resources in various centers. Concerning the efficacy of oral gonadotropin-releasing hormone antagonists (i.e., elagolix, relugolix, and linzagolix), they were shown to have a rapid impact on heavy menstrual bleeding (HMB) in >70% of women. When used without add-back therapy, these drugs cause a significant reduction in fibroid volume, namely, approximately 50% from baseline to week 24. Further studies are required to determine the best protocol and optimal dosage if a reduction in myoma volume is the main goal, as in case of myoma-related infertility.
Topics: Humans; Female; Leiomyoma; Uterine Neoplasms; Infertility, Female; Treatment Outcome; Fertility; Risk Factors; Uterine Artery Embolization; Uterine Myomectomy
PubMed: 38453041
DOI: 10.1016/j.fertnstert.2024.02.049 -
Journal of Obstetrics and Gynaecology... Nov 2023
Topics: Humans; Peritoneal Neoplasms; Leiomyoma; Diagnosis, Differential
PubMed: 37977722
DOI: 10.1016/j.jogc.2021.12.002 -
Journal of Obstetrics and Gynaecology... Nov 2023
Topics: Female; Humans; Adenomyosis; Leiomyoma; Uterine Neoplasms
PubMed: 35276428
DOI: 10.1016/j.jogc.2022.02.125 -
The Journal of Foot and Ankle Surgery :... 2023Angioleiomyoma is a benign tumor, which arises from the smooth muscle. It comprises approximately 4.4% of all benign soft tissues' neoplasms and they are commonly... (Review)
Review
Angioleiomyoma is a benign tumor, which arises from the smooth muscle. It comprises approximately 4.4% of all benign soft tissues' neoplasms and they are commonly located at the lower extremities. They are most frequently found in middle-aged women. Angioleiomyoma is usually presented as a painful solitary lesion in the subcutaneous tissue. Due to the lack of evidence in the literature, the aim of this current concepts review was to provide foot and ankle surgeons the most updated and useful information for diagnosis and management of foot or ankle's angioleiomyoma. The possible diagnosis of angioleiomyoma is rarely thought of before surgery. X-ray, US, MRI, aspiration, scintigraphy, CT and EMG make part of the diagnostic tools available and angioleiomyoma's main characteristics in each of the exams are detailed. Angioleiomyoma cannot be neglected as consequence of delay or mistreatment increases morbidity and the potential risk to malignant transformation.
Topics: Middle Aged; Humans; Female; Ankle; Angiomyoma; Lower Extremity; Soft Tissue Neoplasms; Ankle Joint
PubMed: 36941142
DOI: 10.1053/j.jfas.2023.02.006