Epidemiological trends and surgical versus non-surgical management of uterine leiomyomas in a tertiary care hospital

Farzana Naznin Mou; Toma Aktar

doi:10.18203/2320-1770.ijrcog20243926

Authors

Farzana Naznin Mou BAVS Maternity Hospital, Dhaka, Bangladesh
Toma Aktar Shaheed Suhrawardy Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243926

Keywords:

Epidemiology, Medical management, Surgical management, Uterine leiomyoma

Abstract

Background: Uterine leiomyomas, commonly known as fibroids, are the most prevalent benign tumors in women of reproductive age, often contributing to significant morbidity due to symptoms like heavy menstrual bleeding, pelvic pain, and infertility. The management of fibroids varies widely and can include medical, surgical, or combined approaches, depending on various patient factors.

Methods: This cross-sectional study observational study was conducted department of obstetrics and gynecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, from January 2022 to July 2022. A total of 100 women with fibroid were considered as study subjects by purposive sampling technique. Data analysis was done by statistical package of social sciences (SPSS) version 20.0.

Results: The majority of patients were aged 31-50 years, with a mean age of 38.48 years, and the most prevalent educational level was HSC (29%). Most patients (56%) were housewives, with 65% residing in urban areas, and 86% were married. The primary management approaches included medical treatment (49%) and surgical interventions (42%), with a smaller group (9%) receiving a combination of both. Oral progesterone was the most commonly used medical therapy (37.90%), while myomectomy was the leading surgical procedure (50.98%).

Conclusions: This study concludes that the majority of patients were between 31 and 50 years old, with a mean age of 38.48 years, and the most common educational attainment was HSC, comprising 29% of the cohort. Most were housewives (56%), predominantly from urban areas (65%), and (86%) were married. Management approaches included medical treatments in 49% of cases, surgical procedures in 42%, and a combined approach in 9%. Among medical therapies, oral progesterone was the most frequently used (37.90%), while myomectomy was the most common surgical intervention (50.98%).

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References

Sparić R. Uterine myomas in pregnancy, childbirth, and puerperium. Srpski Arh Celokupno Lekarstvo. 2014;142(1-2):118-24.

Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-7.

Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol. 2009;113(3):630-5.

Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003;111(8):1037-54.

DeWaay DJ, Syrop CH, Nygaard IE, Davis WA, Van Voorhis BJ. Natural history of uterine polyps and leiomyomata. Obstet Gynecol. 2002;100(1):3-7.

Yang CH, Lee JN, Hsu SC, Kuo CH, Tsai EM. Effect of hormone replacement therapy on uterine fibroids in postmenopausal women- a 3-year study. Maturitas. 2002;43(1):35-9.

Sabry M, Al-Hendy A. Medical treatment of uterine leiomyoma. Reprod Sci. 2012;19(4):339-53.

Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. Am Fam Phys. 2007;75(10):1503-8.

Srilatha J, Malathi V. Prevalence of fibroids: a study in a semiurban area in Telangana, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5247-51.

Wesley IJ, Anju PC, Gopinath S, Ranjeth R, Vijayasenan R. Risk Factors Associated With Uterine Fibroids: A Systemic Review. 2018;5(12):223–5.

Yu O, Scholes D, Schulze-Rath R, Grafton J, Hansen K, Reed SD. A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014. Am J Obstet Gynecol. 2018;219(6):591-e1.

Das R, Jafrin R, Biswas B, Nahar N, Biswas RS. Clinical presentation and operative treatment of leiomyoma of uterus and its outcome. Chattagram Maa-O-Shishu Hosp Med Coll J. 2014;13(2):36-41.

Podder MR, Podder R, Shivkumar PV. Demographic parameters of women with uterine fibroids presenting as abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2018;7(7):2915-21.

Shekhar C, Paswan B, Singh A. Prevalence, sociodemographic determinants and self-reported reasons for hysterectomy in India. Reprod Health. 2019;16:1-6.

Singh S, Thulkar T, Pawanarkar M, Thulkar J. Current practices for treatment of uterine fibroids. J Mid-life Health. 2017;8(4):189-90.

Sohn GS, Cho S, Kim YM, Cho CH, Kim MR, Lee SR. Current medical treatment of uterine fibroids. Obstet Gynecol Sci. 2018;61(2):192-201.

Akhter M, Salam A, Anwar K, Alam M, Shoma AK, Salim M. Clinical profile and management option of fibroid uterus patient. Chattagram Maa-O-Shishu Hosp Med Coll J. 2015;14(2):48-51.

Kulkarni MR, Dutta I, Dutta DK. Clinicopathological study of uterine leiomyomas: a multicentric study in rural population. J Obstet Gynecol India. 2016;66:412-6.