Management options of uterine leiomyoma patients admitted to a tertiary care hospital

Toma Aktar; Farzana Naznin Mou

doi:10.18203/2320-1770.ijrcog20251950

Authors

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

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251950

Keywords:

Uterine leiomyoma, Hysterectomy, Oral contraceptive pill, Dysmenorrhea

Abstract

Background: Uterine fibroids (UFs), or uterine leiomyomas (UL), are the most common benign tumors of the female reproductive system, affecting a significant proportion of women of reproductive age. This study aims to evaluate the management strategies of UFs to optimize treatment approaches and patient outcomes.

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 study highlights that UFs affect 20% to 80% of women by the age of 50, with an estimated global prevalence of 171 million cases. The incidence is 2 to 3 times higher among Black women than White women and first-degree relatives have a 2.2 times greater risk of developing fibroids. Imaging studies suggest that 3% to 7% of untreated fibroids in premenopausal women regress over 6 months to 3 years. Hysterectomy, the definitive treatment, accounts for 40% to 60% of all hysterectomies performed due to fibroids.

Conclusions: In this study, it is observed that women with leiomyoma present with variable signs and symptoms. Menstrual disturbance, dysmenorrhea, pain in the lower abdomen, and anemia were the common clinical features. Almost half of the patients were managed by medical treatment whereas the rest of the portion was managed by either medical or surgical management and a few cases were managed by both medical and surgical treatment.

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References

Sparić R. Uterine myomas in pregnancy, childbirth, and puerperium. Srpski arhiv za celokupno lekarstvo. 2014;142(1-2):118-24. DOI: https://doi.org/10.2298/SARH1402118S

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 Obstetr Gynecol. 2003;188(1):100-7. DOI: https://doi.org/10.1067/mob.2003.99

Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstetr Gynecol. 2009;113(3):630-5. DOI: https://doi.org/10.1097/AOG.0b013e318197bbaf

Ciavattini A, Di Giuseppe J, Stortoni P, Montik N, Giannubilo SR, Litta P, Islam MS, Tranquilli AL, Reis FM, Ciarmela P. Uterine fibroids: pathogenesis and interactions with endometrium and endomyometrial junction. Obstet Gynecol Int. 2013;2013(1):173184. DOI: https://doi.org/10.1155/2013/173184

Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003;111(8):1037-54. DOI: https://doi.org/10.1289/ehp.5787

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. DOI: https://doi.org/10.1097/00006250-200207000-00002

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. DOI: https://doi.org/10.1016/S0378-5122(02)00159-7

Sabry M, Al-Hendy A. Medical treatment of uterine leiomyoma. Reproduct Sci. 2012;19(4):339-53. DOI: https://doi.org/10.1177/1933719111432867

Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. Am Family 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. DOI: https://doi.org/10.18203/2320-1770.ijrcog20175059

Wesley IJ, Anju PC, Gopinath S, Ranjeth R, Vijayasenan R, Amritha MS, et al. Risk Factors Associated with Uterine Fibroids: A Systemic Review. Eur J Pharmaceut Med Res. 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.e1-8. DOI: https://doi.org/10.1016/j.ajog.2018.09.039

Williams ARW. Uterine fibroids-what’s new? F1000Research. 2017;6:2109. DOI: https://doi.org/10.12688/f1000research.12172.1

Shikora SA1, Niloff JM, Bistrian BR, Forse RA BG. Relationship between obesity and uterine leiomyomata. Nutrition. 1991;7(4):251-5.

Bizjak T, Bečić A. Prevalence and Risk Factors of Uterine Fibroids in North-East Slovenia. Gynecol Obstet. 2016;06(01):10-3. DOI: https://doi.org/10.4172/2161-0932.1000350

Ofori EK, Asante M, Antwi WK, Coleman J, Brakohiapa EK, Vincent HK, et al. Relationship Between Obesity and Leiomyomas Among Ghanaian. J Med Applied Biosci. 2012;4(12):1-65.

Soave I, Marci R. From obesity to uterine fibroids: an intricate network. Curr Med Res Opin. 2018;34(11):1877-9. DOI: https://doi.org/10.1080/03007995.2018.1505606

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. DOI: https://doi.org/10.3329/cmoshmcj.v14i2.25717

Kulkarni MR, Dutta I, Dutta DK. Clinicopathological Study of Uterine Leiomyomas: A Multicentric Study in Rural Population. J Obstet Gynecol India. 2016;66(11):4126. DOI: https://doi.org/10.1007/s13224-015-0773-y

Rajendran AB. Clinicomorphological Study of Leiomyoma Associated Endometrial Changes in Correlation with LMP: In a Tertiary Care Hospital in Rural Tamil Nadu. J Clin Diagnostic Res. 2019;13(6):5-8. DOI: https://doi.org/10.7860/JCDR/2019/41034.12909

Shalini Singh TT, Monisha Pawanarkar JT. Current Practices for Treatment of Uterine Fibroids. J Midlife Health. 2018;9:185-90.

Sohn GS, Cho SH, Kim YM, Cho CH, Kim MR, Lee SR. Current medical treatment of uterine fibroids. Obstet Gynecol Sci. 2018;61(2):192-201. DOI: https://doi.org/10.5468/ogs.2018.61.2.192

Das R, Jafrin R, Biswas B, Nahar N, Biswas RSR. 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. DOI: https://doi.org/10.3329/cmoshmcj.v13i2.21061