Uterine fibroids and the endometrium
Carlos Simón, Linda C. Giudice in The Endometrial Factor, 2017
Fibroids are hormonally responsive tumors and are sensitive to both progesterone and estrogen. 17β-Estradiol is associated with increased proliferation of uterine fibroid smooth muscle cells (11,12). Consistent with the hormonally sensitive nature of fibroids, there is a higher prevalence of uterine fibroids in reproductive-age women that then decreases at menopause (13). Uterine fibroids respond not only to systemic steroids but also to locally biosynthesized steroids due to aromatase activity within the fibroid itself (14). Despite the hormone dependence of fibroids, fibroid stem cells express low levels of estrogen and progesterone receptors. These observations suggest that steroid hormones exert their effect on fibroid stem cells via a paracrine mechanism (Figure 9.1).
Gynaecology
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
Women with uterine fibroids may present with heavy and/or irregular menstrual bleeding, anaemia, pressure-type symptoms or infertility, especially if the fibroid is distorting the uterine cavity. The pressure-type symptoms include pelvic discomfort, urinary incontinence, frequency and retention, constipation and backache. When large fibroids are present, back pressure may cause or exacerbate varicosities. Although these symptoms are common, it is important to note that some women with fibroids are asymptomatic. Rarely, women may present acutely with pain arising from torsion of a pedunculated fibroid or red degeneration, especially in pregnancy.
DRCOG MCQs for Circuit B Questions
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Adenomyosis.Means endometriosis within the myometrium.Presents with secondary dysmenorrhoea.Often associated with amenorrhoea.May occur within a uterine fibroid.Predisposes to myometrial leiomyosarcoma.
Hysteroscopic treatment of submucosal fibroids in perimenopausal women: when, why, and how?
Published in Climacteric, 2020
S. G. Vitale, G. Riemma, M. Ciebiera, S. Cianci
Uterine fibroids (also known as leiomyomas or myomas) are the most prevalent clonal neoplasms of the uterus. Fibroids have both smooth muscle and fibroblast components, in addition to a substantial amount of fibrous extracellular matrix, which all contribute to the pathogenetic process. Fibroids are extremely heterogeneous in their pathophysiology, size, location, and clinical symptomatology. They are also part of a range of diseases in which some variants have facets of malignant behavior but overall are benign1. The pathophysiology of uterine fibroids remains poorly understood. The growth and development of fibroids are enhanced and stimulated by both estrogen and progestin exposure1,2. Although the mechanisms by which these hormones influence tumor onset and progression are not fully understood, their actions are mediated, at least partially, by growth factors1,3–5.
Feasibility of the novel vascular disrupting agent C118P for facilitating high-intensity focused ultrasound ablation of uterine fibroids
Published in International Journal of Hyperthermia, 2023
Yue Li, Jinyong Zhang, Changlian Lu, Mingrui Guo, Jue Zhang, Gang Huang, Yicheng Ni, Yini Chen
Animal studies of the HIFU treatment of uterine fibroids is difficult. First, although the animals used for studying uterine fibroids include guinea pigs, rats, mice [15], miniature pigs [16], rhesus macaques [17] and other experimental animals, HIFU equipment for small animals has not been fully developed. Second, uterine fibroids are benign tumors. Animal models of malignant tumors can be established in a short time by tumor cell transplantation, but animal models for benign tumors cannot be established in this manner. Moreover, bladder filling is required for ultrasound localization of the uterus, even if uterine fibroids are successfully developed; although humans can voluntarily perform urine retention, animals cannot. To circumvent these challenges, this study evaluated the efficacy of HIFU in treating uterine fibroids based on its ablative efficacy in other muscle tissues. Herein, the leg muscle tissues of rabbits (instead of uterine fibroids) were selected as ablation sites, and changes in uterine blood vessels and peripheral blood perfusion were evaluated to determine the feasibility of C118P-assisted HIFU for the treatment of uterine fibroids.
High-intensity focused ultrasound treatment for symptomatic uterine fibroids: a systematic review and meta-analysis
Published in International Journal of Hyperthermia, 2022
Ling Yan, Huimin Huang, Jingwen Lin, Ruimei Yu
There are various ways to treat uterine fibroids. Although traditional surgical treatments can resolve the clinical symptoms, they have many disadvantages, such as relatively large trauma, high chances of postoperative complications and long operation time. In recent years, owing to its noninvasive properties, HIFU has attracted a lot of attention for uterine fibroid treatment. Many studies have reported that it offers high treatment efficacy while being safe with few adverse effects. Łozinski et al. [10] conducted a single-center retrospective cohort study with 276 patients and reported that HIFU resolved clinical symptoms of patients with uterine fibroids without increasing spontaneous abortion and other pregnancy-related complications. Moreover, a prospective observational open-label multicenter study conducted by Qu et al. [33] showed that the AMH levels did not significantly change after HIFU treatment with 6-month follow-up, suggesting that HIFU does not affect ovarian function. In 2020, a review conducted by Ciebiera et al. prompted that HIFU is a relatively safe, noninvasive method and is not detrimental to fertility [34]. These properties make HIFU an attractive option for young women with fibroids who wish to plan a pregnancy in the future. However, to know if HIFU is superior to other treatment methods needs further study.
Related Knowledge Centers
- Bladder
- Dysmenorrhea
- Leiomyoma
- Low Back Pain
- Uterus
- Pregnancy
- Dyspareunia
- Frequent Urination
- Heavy Menstrual Bleeding
- Hormone