A Systematic Review of Minimally Invasive Treatments for Uterine Fibroid-Related Bleeding

Zhang, Jiahui; Go, Virginia-Arlene Acosta; Blanck, Jaime Friel; Singh, Bhuchitra

doi:10.1007/s43032-021-00722-z

Cited by 11 publications

(6 citation statements)

References 107 publications

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“…The FIGO 2011 classification of abnormal uterine bleeding facilitates investigations related to the cause, evaluation, management and treatment of abnormal uterine bleeding [ 19 ]. Irrespective of the reason for bleeding, a hysterectomy remains the definitive therapy option [ 20 , 21 , 22 , 23 , 24 ]. For women who are affected by uterine fibroids and prefer conservative management, several medical treatment options are recommended that target fibroids by manipulating their hormonal environment.…”

Section: Discussionmentioning

confidence: 99%

“…Local growth factors are involved in fibroid growth and may mediate the growth effects of steroid hormones on the uterus. Also, genetic factors like Reed’s Bannayan syndrome, Cowden syndrome, and hereditary leiomyomatosis, chromosome 12 translocations that involve chromosome 14, vascular abnormalities and response to injury may play roles in fibroid growth [ 20 , 21 , 22 , 23 , 24 ]. A hysterectomy is associated with the significant risks of every surgical procedure, which include infection, thromboembolic diseases, postoperative bleeding and also a high cost and postoperative morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Tsikouras,

Oikonomou,

Tsatsaris

et al. 2023

JPM

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Uterine artery embolization (UAE) for the treatment of symptomatic uterine fibroids and non-controllable adenomyosis symptoms is a relatively new procedure for organ-preserving therapy. These benign conditions can become symptomatic in about 30% of women between the ages of 35 and 50. The purpose of the UAE either for fibroids or adenomyosis is the elimination of blood loss, the reduction in pain, and bulky or rectal pressure symptoms. The purpose of this study is to present our experience in UAE with the use of hydrogel-coated tris acryl microspheres for the treatment of symptomatic uterine fibroids and adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Tsikouras,

Oikonomou,

Tsatsaris

et al. 2023

JPM

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“…І рубець, який не спроможний, складається з рубцевої тканини і може призвести до механічного розриву матки у допологовий період та під час пологів. Частіше розрив відбувається не по рубцю, а у місці стику рубця з силовим міометрієм [21,23,26].…”

Section: Clinical Experience Of Using the Technique Of Uterine Artery...unclassified

Clinical experience of using the technique of uterine artery embolization in the treatment of submucous uterine fibroids in the Vidar Medical Center, Vinnytsia (2008–2022)

Tregub,

Kondratyuk,

Altman

et al. 2024

RHW

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Myoma of the uterus is a benign neoplasm. The technique of uterine artery embolization (UAE) is used to treat uterine fibroids and is highly effective. The principle of embolization is based on the fact that all blood vessels that supply the uterus end in the endometrium.During UAE small parts are injected – emboli, which are spread along these vessels with the blood flow. In the vessels of the myoma the emboli cannot pass through the capsule of the myoma, so they block the vessels that supply it with blood. This leads to the cessation of blood supply to myomatous nodes, and subsequently there is a decrease in the size of these nodes, on average by 50–60% during the year, with a gradual decrease during the following years of life.This minimally invasive procedure is performed under local anesthesia – after femoral artery puncture, with X-ray control of angiography and intraoperative assessment of blood flow in fibroid nodes using ultrasound (US).Over 15 years of work, 1,400 UAE operations of uterine fibroids have been performed, of which more than 70 cases are UAE of submucosal myomas. Later, when the clinical picture of expulsion of these submucosal nodes appeared, transvaginal myomectomy was performed. Such a combined technique demonstrated high efficiency.The article describes clinical cases of patients who received treatment of large submucosal myoma by the UAE method followed by transvaginal myomectomy of the nascent node. In total, 5 clinical cases are described, the results of ultrasound, macropreparations, and colposcopic images are presented. A clinical case of a uterine myoma, the size of which corresponded to 21 weeks of pregnancy and a volume of 1500 cm3, is presented: after the above complex treatment method the volume of the uterus decreased according to ultrasound examination to 122 cm3. Also, a clinical case of a patient with uterine myoma, massive bleeding, whose hemoglobin level was 67 g/l is described. The patient was performed by UAE followed by transvaginal myomectomy for expulsion of the submucosal node.So, the described complex method of treatment of submucous uterine fibroids demonstrated high efficiency of clinical results.

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“…Високий ризик реінтервенцій [79] Радіочастотний міоліз Доставлення радіочастотної енергії під керуванням ультразвуку безпосередньо для знекровлення ММ лапароскопічним шляхом Добре переноситься і забезпечує швидке відновлення, висока задоволеність пацієнток, поліпшення якості життя, ефективне зменшення симптомів. У середньому за 12 місяців після процедури об'єм ММ зменшується на 45,1%, крововтрати -на 38,3% [81] Потреба в лапароскопії та супутньому застосуванні ультразвуку, додаткових розрізах шкіри, вплив лише на один вузол за одну процедуру (< 8 см у діаметрі) і фокусування абляції по центру при зростанні вузлів по периферії HIFU (керований високоінтенсивний транскутанний ультразвук)…”

Section: малоінвазивна процедураunclassified

Uterine fibroids: synthesis of modern knowledge

Plaksiieva¹,

Tatarchuk²,

Косей³

et al. 2022

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Uterine fibroids is an extremely common tumor of the female reproductive system in the population. The problem of this pathology is the diversity of symptoms, mediated by the variety of sizes and locations of myomas, significant impact on reproductive function and frequent misunderstanding of the tumor nature, which leads to unwarranted hysterectomies, even among young women.Authors review the literature on the basis of modern guidelines, which reveals the potential of preserving methods of treatment of fibroids. It is also attempted to answer the most common questions about this pathology.The incidence of uterine fibroids increases with age. Fibroids are hormone dependent tumors, but the obvious cause has not yet been identified, although various risk factors are known, both modified (e.g., obesity, parity) and unmodified (race, age, etc.). Diagnosis of fibroids is simple – just an examination and ultrasound of the pelvis. Among the organ preservation methods of treatment are currently known medicinal (some of them can be used as mono-method or in combination with other methods), minimally invasive (among which stands out uterine artery embolization, as the most studied, effective and safe method) and surgical – conservative myomectomy, which can be performed by different approaches (laparoscopic, hysteroscopic or laparotomy) depending on the number and location of fibroids. This review considers the issues of fertility in uterine fibroids and after organ preservation technologies for its treatment. Differential diagnosis of uterine fibroids with leiomyosarcoma – a rare tumor and its diagnosis is quite difficult.The development of modern medical science, combining specialties with the formation of multidisciplinary teams (as in the case of collaboration with endovascular surgeons to perform uterine artery embolization) and use of an individual approach depending on the fibroids characteristics and patient needs helps reduce the proportion of hysterectomies for uterine fibroids, preservation of the organ and fertility.

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A Systematic Review of Minimally Invasive Treatments for Uterine Fibroid-Related Bleeding

Cited by 11 publications

References 107 publications

Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Clinical experience of using the technique of uterine artery embolization in the treatment of submucous uterine fibroids in the Vidar Medical Center, Vinnytsia (2008–2022)

Uterine fibroids: synthesis of modern knowledge

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