China
Africa
Explore chapters and articles related to this topic
Surgical Treatment of Fibroids
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Ibrahim Alkatout, Liselotte Mettler
For women who have completed their family planning, hysterectomy is the definitive procedure for relief of symptoms and prevention of recurrence of fibroid-related problems. With increasing experience in laparoscopic hysterectomies, the risk of side effects has become manageable. In relation to the compliance and individuality of the patient, a suitable solution can be either laparoscopic supracervical or total laparoscopic hysterectomy.
GnRH Antagonists in the Treatment of Uterine Fibroids
Published in John C. Petrozza, Uterine Fibroids, 2020
Tejumola Adegoke, Shruthi Mahalingaiah
Timing of the initial cetrorelix dose (follicular phase vs. luteal phase) did not appear to affect the degree of uterine shrinkage. Most patients showed a progressive decrease in serum gonadotropins and estradiol to subnormal levels after the first dose of cetrorelix. However, four patients experienced decreases in uterine volume (mean 225 mL) after 3–4.5 months of treatment despite little or no depression in gonadotropin or estradiol levels. Twelve of fourteen patients who were anemic at the start of the study were observed to have normal hemoglobin levels after 3 months of treatment. Fifteen patients became amenorrheic. Among women who did not undergo hysterectomy, menstrual function returned 1 month after completion of treatment. Reported side effects included hot flashes, increased appetite and decreased libido. These resolved within 2 weeks of discontinuing therapy. Following treatment, three women underwent hysterectomy and 12 were treated with myomectomy. Repeat ultrasound illustrated a recurrence in one myomectomy patient and an increase in uterine volume (77 mL) in one patient who was expectantly managed.
Gynaecology: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
The other surgical option is hysterectomy. This would cure the menorrhagia and remove the mass in the abdomen (1). Hysterectomy removes her fertility and the patient needs to accept this prior to surgery (1). The risks associated with hysterectomy include infection, intraoperative haemorrhage (increased risk with fibroids), risk of damage to urinary tract and bowel, and the rare risk of thrombosis (2). The pros and cons of removing the ovaries at the time of hysterectomy should be discussed and the woman supported in making an informed decision (1). The benefits and risks of HRT, should she opt for a bilateral salpingo-oophorectomy, need to be discussed (1).
Therapeutic dose and long-term efficacy of high-intensity focused ultrasound ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images
Published in International Journal of Hyperthermia, 2023
Yangyang Wang, Chunmei Gong, Min He, Zhenjiang Lin, Feng Xu, Song Peng, Lian Zhang
Conventional treatments for symptomatic uterine fibroids include medication, myomectomy and hysterectomy. Recently, uterine artery embolization (UAE) has become a routine treatment for uterine fibroids in developed countries. Medication can be used to effectively control fibroid-related symptoms, but symptoms can easily recur after medication withdrawal. In addition, serious side effects of some medications have limited their role in the management of uterine fibroids. Myomectomy is a standard treatment for patients with uterine fibroids who wish to retain their uterus, but the cumulative recurrence rates at 12 and 24 months after myomectomy were high [5]. Hysterectomy is a definitive treatment for uterine fibroids, but this operation is not suitable for patients who wish to remain fertile. UAE is less invasive than surgery and can be used to effectively control the symptoms caused by uterine fibroids, but its adverse effects on ovarian function, have limited the clinical application of this technique.
Clinical evaluation of high-intensity focused ultrasound ablation combined with mifepristone and levonorgestrel-releasing intrauterine system to treat symptomatic adenomyosis
Published in International Journal of Hyperthermia, 2023
Hui Zhu, Qimin Ma, Guoling Dong, Lijun Yang, Yang Li, Shumin Song, Yanchao Mu
Adenomyosis is a benign disorder characterized by uterine enlargement, mainly caused by endometrial glands and stroma invading the myometrium. This disorder occurs among people of reproductive age. Approximately 20% of patients are younger than 40 years old, and the remaining 80% are 40–50 years old [1]. The main symptoms are progressive dysmenorrhea, hypermenorrhea, and infertility [2]. Women with serious adenomyosis experience physical and mental health problems, including sleep and eating disorders and depression [3,4]. Currently, hysterectomy is the gold standard radical treatment for adenomyosis and the most effective way to control symptoms and achieve high satisfaction rates. However, hysterectomy is unsuitable for young patients or women who desire fertility. In addition, hysterectomy can result in complications such as wound infections, genitourinary tract injuries, vaginal cuff dehiscence, urinary incontinence, sexual dysfunction, vaginal dryness, hormonal changes, gastrointestinal tract injuries, pelvic organ prolapse, and pelvic organ fistula disease [5].
Magnetic resonance imaging parameters in predicting the ablative efficiency of high-intensity focused ultrasound for uterine fibroids
Published in International Journal of Hyperthermia, 2021
Chunmei Gong, Zhenjiang Lin, Fajin Lv, Lian Zhang, Zhibiao Wang
Uterine fibroids are the most common benign gynecological tumors in women of reproductive age. The prevalence of uterine fibroids varies across races and ranges from 20% to 80% [1]. Approximately half the patients have symptoms of menorrhagia, pelvic pain or infertility. Conventional treatment for uterine fibroids includes hysterectomy, myomectomy, and uterine artery embolization (UAE) [2,3]. Hysterectomy is a definitive treatment for uterine fibroids. However, it is not suitable for patients who wish to retain their uterus. Myomectomy is a treatment of choice for patients wishing to conceive, but the reintervention rate is high [4]. Uterine artery embolization (UAE) is an alternative treatment for uterine fibroids but severe adverse effects have limited its application [5]. High-intensity focused ultrasound (HIFU) has been widely used as a noninvasive treatment in the management of uterine fibroids. Previous studies have demonstrated that this technique is safe and effective in the treatment of uterine fibroids [6–8]. However, in clinical practice, it was found that HIFU is not suitable for some patients. Therefore, optimization of these indicators is the key to achieving better results.