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Presse Medicale (Paris, France : 1983) 2013Myomas induce menorrhagia and pelvic pain, and increase the risk of infertility and obstetrical complications. Symptomatic sub-mucosal myomas are classically treated by...
Myomas induce menorrhagia and pelvic pain, and increase the risk of infertility and obstetrical complications. Symptomatic sub-mucosal myomas are classically treated by hysteroscopic resection. Symptomatic interstitial and sub-serosal myomas may be treated by myomectomy, either by laparotomy or laparoscopy according to their number and size. Prophylactic myomectomy is not recommended to prevent from obstetrical complications or the risk of leiomyosarcoma. Although all myomas have a negative effect on fertility, the removal of sub-mucosal myomas is the sole recommendation to improve spontaneous fertility or assisted reproduction technology.
Topics: Female; Fertility; Humans; Infertility, Female; Leiomyoma; Myoma; Treatment Outcome; Uterine Myomectomy; Uterine Neoplasms
PubMed: 23582900
DOI: 10.1016/j.lpm.2013.02.317 -
European Review For Medical and... Apr 2016Uterine myomas are one of the most common benign tumours, occurring in 20-40% of women of reproductive age. Ulipristal acetate (UPA) is a possible option for medical...
OBJECTIVE
Uterine myomas are one of the most common benign tumours, occurring in 20-40% of women of reproductive age. Ulipristal acetate (UPA) is a possible option for medical treatment of myomas. It induces amenorrhea and can reduce myoma volume before surgical treatment. Since its introduction in our department, we uncovered an unknown effect: migration of myoma.
CLINICAL CASE REPORTS
We describe three clinical case of myoma migration following three months UPA pre-operative treatment. The first woman presented with a FIGO 2 myoma, which migrated in FIGO 3. A previously planned hysteroscopy converted into a laparoscopy. The second woman also presented with a FIGO 2 myoma, which migrated in FIGO 3. Initially, a hysteroscopy was planned, but ultimately surgery was no longer required. The third woman presented with a FIGO 2-5 myoma, which migrated in FIGO 1. The previously planned laparoscopy converted into a vaginal myomectomy.
CONCLUSIONS
UPA induces a proapoptotic and anti proliferative effect of leiomyoma cells. It reduces expression of VEGF and reduces collagen deposition in the extracellular matrix. These mechanisms could induce migration of myoma. UPA as pre-operative treatment can induce migration of myoma and, therefore, can lead to perioperative conversion of surgery.
Topics: Female; Humans; Leiomyoma; Myoma; Neoplastic Cells, Circulating; Norpregnadienes; Pregnancy; Uterine Myomectomy; Uterine Neoplasms
PubMed: 27160112
DOI: No ID Found -
RoFo : Fortschritte Auf Dem Gebiete Der... Mar 2021
Topics: Adolescent; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Myoma; Treatment Outcome; Uterine Neoplasms
PubMed: 32731268
DOI: 10.1055/a-1214-7000 -
PloS One 2023To evaluate the influence of myoma characteristics on cesarean myomectomy and to demonstrate its additional advantages.
OBJECTIVES
To evaluate the influence of myoma characteristics on cesarean myomectomy and to demonstrate its additional advantages.
METHODS
Retrospective data were collected from 292 women with myomas who had undergone cesarean section at Kangnam Sacred Heart Hospital between 2007 and 2019. We performed subgroup analysis according to the type, weight, number, and size of myomas. Preoperative and postoperative hemoglobin levels, operative time, estimated blood loss, length of hospital stay, incidence of transfusion, uterine artery embolization, ligation, hysterectomy, and postoperative complications were compared among subgroups.
RESULTS
There were 119 patients who had cesarean myomectomy and 173 who had cesarean section only. An increase in postoperative hospitalization and operation time was observed in the cesarean myomectomy group compared to that in the caesarean section only group (mean difference, 0.7 days, p = 0.01, 13.5 minutes, p <0.001). Estimated blood loss, hemoglobin differences, and transfusion rates were higher in the cesarean myomectomy than in the cesarean section only group. There were no differences in postoperative complications (fever, bladder injury, and ileus) between the two groups. No hysterectomy cases were reported in the cesarean myomectomy group. In subgroup analysis, the larger and heavier the myoma, the higher the risk of bleeding that led to transfusion. Estimated blood loss, differences in hemoglobin, and transfusion rate increased depending on myoma size and weight. A significant increase in postoperative hospitalization was observed in women with larger and heavier myomas. However, there was no statistical difference among the three types of myomas.
CONCLUSION
In cesarean myomectomy, larger (≥ 10 cm), and heavier myomas (≥ 500 g), were associated with postoperative outcomes, but not the number or type of myoma. The safety of cesarean myomectomy is not inferior to that of caesarean section only, considering its positive effects such as gynecological symptom relief and avoidance of the next surgery.
Topics: Female; Humans; Pregnancy; Uterine Myomectomy; Leiomyoma; Uterine Neoplasms; Cesarean Section; Retrospective Studies; Myoma; Postoperative Complications; Risk Factors; Laparoscopy
PubMed: 36893190
DOI: 10.1371/journal.pone.0280953 -
Journal of Psychosomatic Obstetrics and... Jun 2020The aim of this study was to explore a possible relation between myoma-related anxieties and general state or trait anxiety or psychological distress, to get a better...
The aim of this study was to explore a possible relation between myoma-related anxieties and general state or trait anxiety or psychological distress, to get a better understanding of the impact of anxiety on the patients. This prospective study was conducted at the myoma clinic of a large university hospital in a major European city from November 2016 to February 2017. Patients completed standardized questionnaires on myoma-related fears, the State Trait Anxiety Inventory (STAI), and the Kessler 10. Eighty-five out of 88 women agreed to participate. State-anxiety on the STAI had a mean of 49.4 (11 points above the norm ( < .001)), and trait-anxiety had a mean of 42.0 (5 points above the norm ( = .001)). Thirty-seven percent of the patients had distress values on the K10 above the norm (defined as <20). More myoma-related fears correlated with higher scores on the Kessler and STAI. The scores were not related to the level of information about myomas or duration of illness. Myoma-related fears correlated with higher mental distress and elevated state and trait anxiety levels. Thus, physicians can contribute to the overall well-being of patients when they relieve them of the myoma-related anxiety. Further research is needed to determine whether treatment has any impact on anxiety or mental distress.
Topics: Adult; Anxiety; Berlin; Female; Humans; Leiomyoma; Middle Aged; Myoma; Personality Inventory; Prospective Studies; Surveys and Questionnaires; Uterine Neoplasms; Young Adult
PubMed: 31179813
DOI: 10.1080/0167482X.2019.1624951 -
Seminars in Ultrasound, CT, and MR Feb 2021Uterine fibroids embolization is a safe and effective organ sparing treatment for fibroid-related symptoms based on a broad range of published evidence including... (Review)
Review
Uterine fibroids embolization is a safe and effective organ sparing treatment for fibroid-related symptoms based on a broad range of published evidence including randomized-controlled trials. Indication to treatment is usually the presence of symptomatic uterine fibroids. In this review, a systematic search of journal articles relevant to the treatment of symptomatic uterine fibroids was conducted, with a special focus on the indication to treatment, technique, procedural outcomes and pain control. All clinical trials published in English language, representing original research, and reporting clinical outcomes associated with interventions for the management of symptomatic uterine fibroids were considered.
Topics: Diagnostic Imaging; Endovascular Procedures; Female; Humans; Leiomyoma; Myoma; Treatment Outcome; Uterine Neoplasms; Uterus
PubMed: 33541585
DOI: 10.1053/j.sult.2020.07.002 -
Seminars in Ultrasound, CT, and MR Feb 2021Uterine fibroids are common benign tumors that affect the female reproductive tract. They are responsible for considerable morbidity and deterioration of life quality.... (Review)
Review
Uterine fibroids are common benign tumors that affect the female reproductive tract. They are responsible for considerable morbidity and deterioration of life quality. The main advantages offered by mini invasive techniques are low grade of invasiveness and short times of hospitalization. The most diffuse technique is uterine artery embolization (UAE). Common concerns with UAE include postprocedural pain, postembolization syndrome, and risk of infection. Image-guided thermal ablation techniques like radiofrequency ablation, percutaneous microwave ablation, and imaging-guided high-intensity focused ultrasound were introduced to overcome the side effects related to UAE and surgery. The aim of this review is to briefly analyze the ablative procedures and their role in the management of symptomatic fibroids, and to describe the safety profile and outcomes of these modalities.
Topics: Ablation Techniques; Diagnostic Imaging; Female; Humans; Leiomyoma; Myoma; Treatment Outcome; Uterine Neoplasms; Uterus
PubMed: 33541590
DOI: 10.1053/j.sult.2020.08.004 -
Fukushima Journal of Medical Science Aug 2022Parasitic myoma (PM) is a rare disease in which multiple leiomyomas are intraperitoneally formed. Recently, an increasing number of cases due to specimen morcellation...
Parasitic myoma (PM) is a rare disease in which multiple leiomyomas are intraperitoneally formed. Recently, an increasing number of cases due to specimen morcellation during minimally invasive surgery has been reported. We present the first case of a PM identified intraoperatively during laparoscopic hysterectomy. A 40-year-old Japanese multiparous woman presented to our hospital with heavy menstrual bleeding. She had no history of previous surgery. Magnetic resonance imaging showed uterine myomas. As the patient did not wish for further pregnancy, she underwent oral gonadotropin-releasing hormone antagonist therapy followed by a total laparoscopic hysterectomy. Intraoperatively, we identified a thumb-sized tumor on the left side of the peritoneum. Histopathological examination showed evidence of benign leiomyoma.
Topics: Adult; Female; Humans; Laparoscopy; Leiomyoma; Myoma; Pregnancy; Uterine Myomectomy; Uterine Neoplasms
PubMed: 35650067
DOI: 10.5387/fms.2022-08 -
Seminars in Ultrasound, CT, and MR Feb 2021Uterine fibroids are the most common neoplasm in women. These lesions may be associated with impaired fertility and adverse obstetric outcomes. Medical treatment,... (Review)
Review
Uterine fibroids are the most common neoplasm in women. These lesions may be associated with impaired fertility and adverse obstetric outcomes. Medical treatment, myomectomy, hysterectomy and uterine artery embolization have been employed for the management of uterine fibroids. Focused ultrasound surgery (FUS) is a relatively recent technique that relies on mechanical and thermal energy of ultrasound for the ablation of a target tissue under an imaging guidance, that can be either ultrasound (US-guided FUS, USgFUS) or magnetic resonance (MR-guided FUS, MRgFUS). Pre- and peri-menopausal women are potential candidates for treatment; however, individual criteria need to be evaluated in order to establish the eligibility for the procedure. FUS procedure can be performed in an outpatient setting; it is a safe and effective treatment that has demonstrated to reduce symptoms associated with uterine fibroids. The adverse event rate is 8.7% and only 0.2% of patients experiences major complications. Pregnancy is possible after the treatment, and no damage to the endometrium has been observed following FUS procedure.
Topics: Female; High-Intensity Focused Ultrasound Ablation; Humans; Leiomyoma; Magnetic Resonance Imaging, Interventional; Myoma; Treatment Outcome; Ultrasonography, Interventional; Uterine Neoplasms; Uterus
PubMed: 33541586
DOI: 10.1053/j.sult.2020.08.001 -
Asian Journal of Surgery Jun 2022
Topics: Female; Humans; Hysterectomy; Laparoscopy; Leiomyoma; Myoma
PubMed: 35227561
DOI: 10.1016/j.asjsur.2022.01.056