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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 -
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 -
Taiwanese Journal of Obstetrics &... Dec 2009Since the initial description of laparoscopic myomectomy (LM) in 1979, many reports of this technique have been published worldwide. The indications for LM have grown in... (Review)
Review
Since the initial description of laparoscopic myomectomy (LM) in 1979, many reports of this technique have been published worldwide. The indications for LM have grown in line with improvements in laparoscopic techniques and instruments over the last decade. LM offers several benefits to patients but remains a challenging technical procedure that is associated with high surgical morbidity and a high incidence of blood transfusion. LM procedures include excision of the myoma(s), repair of myometrium, and removal of the myoma from the abdomen. The control of operative blood loss is crucial, especially in the case of large intramural fibroids. Different studies have found wide variations in the incidence of recurrence after LM. Ultrasound imaging and Doppler velocimetry can be used to assess uterine scars after LM. Uterine rupture during pregnancy is a serious concern after LM, and all published cases report the occurrence of rupture before the start of labor. Surgical strategies are needed to overcome these problems associated with LM. Although LM is minimally invasive in terms of the wound, it remains an advanced and invasive procedure. An appropriate management strategy is required for each patient, and careful discussion and counseling regarding all the issues are necessary.
Topics: Female; Humans; Laparoscopy; Leiomyoma; Myometrium; Uterine Neoplasms
PubMed: 20045753
DOI: 10.1016/S1028-4559(09)60321-1 -
Pakistan Journal of Medical Sciences 2022To investigate the clinicopathological features of patients with uterine myoma and to analyze and summarize factors affecting patient prognosis.
OBJECTIVES
To investigate the clinicopathological features of patients with uterine myoma and to analyze and summarize factors affecting patient prognosis.
METHODS
This study retrospectively investigated records of uterine myoma patients treated at Huzhou Central Hospital between June 2018 and May 2020. A total of 149 patients were included in this study, including 121 patients with good prognosis and 28 patients with poor prognosis. Clinical and pathological characteristics, including age, average body mass index (BMI), menopausal status, average lesion diameter, presence of hypertension or diabetes mellitus, operation method, myoma type, location, and quantity, number of fibroids, and presence of pelvic adhesion were analyzed via multivariate analysis.
RESULTS
Among the 149 patients with uterine uterine myoma, 92 had anterior wall uterine myoma, 36 had posterior wall uterine myoma, and 21 had uterine fundus uterine myoma. In terms of location, 94 cases were intramural and 55 cases were subserosal. Quantity-wise, 107 had 1-3 myomas while 42 had four or more. Moderate or more severe pelvic adhesions were present in 33 cases. Univariate analysis showed significant differences in age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity between patients with good and poor prognosis. Multivariate analysis showed that age, surgical method, uterine myoma type, uterine myoma location, uterine myoma quantity, and pelvic adhesion severity were risk factors affecting the prognosis.
CONCLUSION
Many prognostic factors, including age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity are linked to uterine myoma patient prognosis.
PubMed: 35991253
DOI: 10.12669/pjms.38.6.5455 -
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 -
Head and Neck Pathology Dec 2021This report describes a case of an adult rhabdomyoma (ARM) occurring in the oral cavity. A 47-year-old man was referred for the diagnosis of a painless,...
This report describes a case of an adult rhabdomyoma (ARM) occurring in the oral cavity. A 47-year-old man was referred for the diagnosis of a painless, well-circumscribed, submucous nodule located on the floor of the mouth, measuring approximately 6.0 cm in length. Computed tomography revealed a well-defined, solid, and hypodense mass. A benign salivary gland or mesenchymal tumor were the main diagnostic hypotheses. Under local anesthesia, the patient underwent surgical excision. Microscopically, the tumor comprised large polygonal well-defined cells with abundant, eosinophilic granular cytoplasm with cross striations. No atypia or mitosis was observed. The cells were positive for muscle-specific actin, desmin, and sarcomeric alpha-actin. Based on these features, a diagnosis of ARM was established. No recurrence was observed after 48 months. Although rare, ARM should be considered in the differential diagnosis of oral submucosal nodules, especially those located on the floor of the mouth.
Topics: Humans; Male; Middle Aged; Mouth Neoplasms; Rhabdomyoma
PubMed: 34378165
DOI: 10.1007/s12105-021-01371-z -
JSLS : Journal of the Society of... 2008Numerous procedures have been developed in recent decades that claim to provide significant improvement in myoma status without hysterectomy. However, what is the cost... (Review)
Review
Numerous procedures have been developed in recent decades that claim to provide significant improvement in myoma status without hysterectomy. However, what is the cost in time and money of these procedures? This is a review of the current literature regarding these recent procedures to determine which, if any, is the best treatment for myomas. We conducted a search of PubMed using the terms "bipolar-, cryo-, radiofrequency, laparoscopic-, focused high-energy MRI-guided ultrasound, and MRI-guided laser myolysis" to identify reports of the various procedures. Based on these published reports, we describe the various types of myolysis performed in multiple patients in outpatient facilities including patient outcomes, complications, cost, and efficiency of the procedures.
Topics: Catheter Ablation; Cryosurgery; Female; Humans; Laparoscopy; Laser Therapy; Myoma; Uterine Artery Embolization; Uterine Neoplasms
PubMed: 19275864
DOI: No ID Found -
JBRA Assisted Reproduction Oct 2021Submucous myomas have negative effects on fertility. To maintain fertility, conservative treatment should be suggested to women who wish to become pregnant, especially...
Submucous myomas have negative effects on fertility. To maintain fertility, conservative treatment should be suggested to women who wish to become pregnant, especially young patients. The patient was a 33-year-old woman, who had had secondary infertility for 3 years. Upon vaginal ultrasound, we noticed a submucous myoma measuring 26 mm x 31 mm with a compressive effect on the anterior surface of the endometrium. Ovarian reserve was low. The gold standard of myoma treatment is surgical intervention. But, for the following reasons: the adverse effects of surgery on the endometrium (intrauterine adhesion), the patient's refusal to undergo a myomectomy and her request for pregnancy, our strategy for treating was to reduce volume of submucous myoma and start the assisted reproductive techniques (ART) cycle, simultaneously. We administered three courses of Gonadotropin-releasing hormone analogues (GnRHa) and then induced controlled ovarian hyperstimulation. Ovum pick up was done. Finally, we transferred two embryos (4 and 6 cells). In subsequent patient visits, βhCG was positive after 14 days. At the last patient visit, the heart of the embryo was formed. From this finding, it may be concluded that combined GnRHa and ART is the treatment of choice for infertile women with uterine submucous myoma, considering the reduced ovarian reserve and response.
Topics: Adult; Female; Humans; Infertility, Female; Leiomyoma; Myoma; Pregnancy; Reproductive Techniques, Assisted; Uterine Neoplasms
PubMed: 34415133
DOI: 10.5935/1518-0557.20210042