Current and emerging treatments for uterine myoma – an update

Abstract

Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indications. Hysterectomy has its place in myoma management in its definitiveness. However, myomectomy, rather than hysterectomy, should be performed when subsequent childbearing is a consideration. Preoperative gonadotropin-releasing hormone analog treatment before myomectomy decreases the size and vascularity of the myoma but may render the capsule more fibrous and difficult to resect. Uterine artery embolization is an effective standard alternative for women with large symptomatic myomas who are poor surgical risks or wish to avoid major surgery. Its effects on future fertility need further evaluation in larger studies. Serial follow-up without surgery for growth and/or development of symptoms is advisable for asymptomatic women, particularly those approaching menopause. The present article is incorporated with multiple clear clinical photographs and simplified elaboration of the available management options for these tumors of uterine smooth muscle to facilitate clear understanding.

Three Coagulation Related Mutations and Increased Risk of Myoma in Women of Fars Province

“…Abbreviations: OR, odds ratio; 95%CI, confidence interval. Uterine myomas is the most prevalent tumor in women's reproductive or even after menopause age [1]. Since tumorigenesis and thrombosis closely connected, involved factors in thrombosis could be considered as genetic markers for myoma tumor, and therapeutic targets.…”

“…Myoma is one of the most frequent tumors in the women's genital tract, especially in women of reproductive and menopause age [1]. Although the risk factors of myoma are not completely clear, some molecules such as estrogen, progesterone and the growth factors such as insulin like transforming growth factor β (TGF β) [2] and fibroblast growth factor (FGF) have been found related to the myoma [3].…”

Symptoms Improvement after Uterine Artery Embolization for Myomas Management

“…Most women have no or mild symptoms, and never need treatment, but reassurance and careful follow up. For about 30% of them, however, symptoms can be a problem and interfere in their quality of life [2].…”

Endovascular occlusion of uterine arteries in the treatment of symptomatic uterine leiomyoma

“…Частота встречаемости этого заболевания по данным аутопсийного материала колеблется от 70 до 85%. Симптомная миома матки в возрасте от 20 до 30 лет встречается у 5-7% женщин, в 30-40 летнем возрасте у 20-25% женщин, достигших пременопаузального возраста частота лейомиом достигает 30-35%, а по данным некоторых авторов и до 40% [1,2,3].…”