DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173500

Fibromyoma of the uterus and its surgical management

Rajeshwari Laxman Khyade, Rakhi M. More

Abstract


Background: Uterine fibroids are the commonest tumor affecting the female reproductive tract. In many instances they are asymptomatic, but in some women there does appear to be an association with heavy menstrual blood loss and subfertility. Classically treatment has been surgical with hysterectomy the most common approach for women who have completed their fertility and myomectomy for those who wish to conceive. The surgery can be carried out laparoscopically, vaginally and abdominally, although all routes are associated with an appreciable rate of morbidity. The aims of this study are (i) to formulate the line of surgical treatment of fibromyomas according to age and parity of the patient, (ii) to assess their efficacy, safety and long-term outcome.

Methods: A study of 50 patients attending the Obstetrics and Gynecology OPD of a tertiary care institute was conducted over a period of one year. Detailed history and examination of the patients were done.

Results: The best surgical options for individual patients were evaluated according to age and parity of the patient. Various surgical options were Hysterectomy and Myomectomy.

Conclusions: Uterine fibroids can cause multiple bleeding and pain symptoms, which might have a negative impact on women's life, influencing their sexual, social and work life. Despite these consequences uterine fibroid data, especially on epidemiology, symptomatology and their impact on women's health are still limited and further research is required.


Keywords


Abdominal hysterectomy, Fibromyomas, Myomectomy, Salphingo-oophorectomy, Vaginal hysterectomy

Full Text:

PDF

References


Wallach EE, Vlahos NF. Uterine myomas: an overview of development, clinical features and management. Obstet Gynecol. 2004;104:393-406.

Marshall LM, Spiegelman D, Barbieri RL. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90:967-73.

Lumsden MA, Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum Reprod. 2002;17(2):253-9.

Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36(4):433-45.

Poddar DL, Fibromyoma of the Uterus, J Obstet and Gynecol of India. 1957:4;109-14.

Reddy BD, Malathy P, Fibromyoma uterus J Obstet and Gynecol of India. 1963;13:54-61.

Pinto Rosario Y. Uterine Fibromyomas J Obstet and Gynecol of India. 1968;18:101-7.

Gogoi MP, Purabi Gogoi, Debjani Kar. Fibroids in parous women J Obstet and Gynecol of India. 1978;28:1053-5.

Gautam A, Vijay A, Pratiba V. Myomectomy-A study of 50 cases J Obstet Gynecol India. 1991;41:540-2.

Bhat RA, Kumar PN. Experience with Uterine Leiomyomas at a Teaching Referral Hospital in India. J Gynecol Surg. 2007;22(4):143-50.

Ezeama CO, Ikechebelu JI, Obiechina NJ, Ezeama NN. Clinical presentation of uterine fibroids in Nnewi, Nigeria: a 5-year review. Ann Med Health Sci Res. 2012;2(2):114-8.

Berek JS. Berek and Novaks Gynecology. 14th Ed. Lippincott Williams and Wilkins;2007:703.

Chhabra S, Jaiswal Meenakshi, Vaginal Management of uterocervical myomas. J Obstet Gynecol. 1996;46:260-3.

Stewart EA. Uterine Fibroids, Lancet. 2001;357(9252):293-8.

Iverson RE, Chelmow D, Strohbehn K, Waldman L, Evantash EG. Relative morbidity of abdominal hysterectomy and myomectomy for management of uterine leiomyomas. Obstet Gynecol. 1996;88(3):415-9.

Ecker JL, Foster JT, Firiedman AJ, Abdominal hysterectomy or abdominal myomectormy for symptomatic leiomyoma a comparison of preopertive demography and posteoperative morbidity. J Gynecol Surg. 1995;11:11-8.

Alternatives to hysterectomy in the management of leiomyomas. National guidelines American college of Obetetrics and Gyneacology. NGC :006762, 2000 May. Revised 2008 Aug; Reaffirmed 2012.

Meikle SF, Nugent EW, Orleans M. Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstetr Gynecol. 1997;89(2):304-11.

Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Women's Health. 2012;12(1):6.