EMAS position statement: Management of uterine fibroids

Pérez‐López, Faustino R.; Ornat, Lía; Ceaușu, Iuliana; Depypere, Herman; Erel, C. Tamer; Lambrinoudaki, Ιrene; Schenck‐Gustafsson, Karin; Simoncini, Tommaso; Trémollières, Florence; Rees, Margaret

doi:10.1016/j.maturitas.2014.06.002

Cited by 100 publications

(72 citation statements)

References 128 publications

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“…The bleeding can lead to chronic anemia and severely reduced quality of life. 5 This benign tumor of the muscle layer of the uterus is hormonally dependent, developing after puberty and tending to shrink after menopause. 6,7 The factors that initiate tumorigenesis are not known, but both estrogen and progesterone are important for growth (reviewed by Bulun 8 ).…”

Section: Introductionmentioning

confidence: 99%

A Prospective, Ultrasound-Based Study to Evaluate Risk Factors for Uterine Fibroid Incidence and Growth: Methods and Results of Recruitment

Baird

Harmon

Upson

et al. 2015

Journal of Women's Health

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Background: Uterine fibroids are common, benign, smooth-muscle tumors that can cause major morbidity for reproductive-age women, often requiring invasive treatment. Despite this personal and public health burden, no prior study has attempted to periodically screen fibroid-free women with ultrasound to detect incident disease and identify risk factors. Methods: We designed a study to prospectively investigate development of fibroids by enrolling women without a clinical diagnosis of fibroids and screening for fibroids with ultrasound at baseline. Enrollment procedures included extensive questionnaires and specimen collection (blood, urine, vaginal swabs). The cohort is followed at approximately 20-month intervals. At each follow-up there are updates to the questionnaire data, further specimen collection, and an ultrasound examination. We identify incident disease and measure tumor growth. The two exposures of primary interest are vitamin D insufficiency and reproductive tract infections. This manuscript provides a detailed description of the study methods, recruitment results, and participant characteristics. Results: The Study of Environment, Lifestyle and Fibroids enrolled 1,696 African American women aged 23-34 years. ''Family and friends'' was a leading recruitment source. More than 95% of participants contributed all the requested biological specimens at baseline. Study ultrasound examinations revealed undiagnosed fibroids in 378 women (22% of participants). The retention rate for the first follow-up was 87%. Conclusions: Study design aspects likely to be important for long-term studies in young African Americans include personalized recruitment, multiple steps to the enrollment process that rely on the initiative of the participant, and methods for tracing highly mobile study subjects.

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Section: Introductionmentioning

confidence: 99%

A Prospective, Ultrasound-Based Study to Evaluate Risk Factors for Uterine Fibroid Incidence and Growth: Methods and Results of Recruitment

Baird

Harmon

Upson

et al. 2015

Journal of Women's Health

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“…Of existing alternatives to standard therapies, HIFU appears to be one of the most promising in that its advantages include: (a) noninvasiveness, (b) patient wellbeing due to avoidance of scar formation (c) low risk of immune responses as will be discussed below, (d) accuracy and (e) ease of use, the latter two based on our own clinical experience. HIFU is already widely applied in clinical practice and is used to treat, among other diseases, breast lesions [19], uterine fibroids [20] and prostate cancer [21]. It is also further being developed to treat kidney and liver tumors [22].…”

mentioning

confidence: 99%

Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response

Korkusuz

Sennert

Fehre

et al. 2015

Fortschr Röntgenstr

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Purpose: The aim of this study was to assess the effectiveness of high intensity focused ultrasound (HIFU) in reducing thyroid nodule volume while preserving thyroid function as measured by immunological response. Materials and Methods: 12 patients (9 females) whose average age was 56.9 years (37???81) were treated with HIFU in an ambulatory setting. All patients had a single benign thyroid nodule treated in one HIFU session. The median nodular outline volume (NOV) was 3.4?ml (range 0.6???5.0?ml). The therapeutic ultrasound probe (Echopulse? THC900?888-H) used works with a frequency of 3?MHz, reaching temperatures of 80???90? C and a mean output between 87.6 and 192.8?W. To assess possible effects of HIFU on thyroid function, serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobulin (hTg) and antibodies against thyroglobulin (TAbs), thyrotropin receptors (TRAbs) and thyroid peroxidase (TPOAbs) were measured at enrollment, 24-hours post-HIFU treatment and at 3-month follow-up.Pre- post thyroglobulin reduction was measured to evaluate the success of ablation and the nodular outline volume (NOV) was evaluated at baseline and the 3-month follow-up to assess effectiveness. Results: All measured hormone levels were within normal ranges and remained stable (p?>?0.05). No clinically meaningful immune reaction was induced (p?>?0.05). Thyroglobulin serum levels increased significantly at 24 hours after ablation (p?

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“…Данные по этому вопросу мало-численны, однако практически во всех исследовани-ях не установлено достоверного увеличения объема миоматозных узлов на фоне непрерывного комби-нированного режима МГТ. При субмукозном росте миомы матки МГТ увеличивает риск аномальных маточных кровотечений [15].…”

Section: выводыunclassified