Fibroid Surgery and Long-Term Improvement in Bladder Symptoms

Simula, Natasha K.; Rikhraj, Kiran; Koenig, Nicole; Lee, Terry; Geoffrion, Roxana

doi:10.1016/j.jogc.2019.05.016

Cited by 3 publications

(8 citation statements)

References 15 publications

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“…23,31,32 A significant improvement was also noted 4–6 years after surgical debulking (myomectomy or hysterectomy) (n=30), with a median score change of −28.4 (interquartile range −58.8 to −0.9). 33,34…”

Section: Resultsmentioning

confidence: 99%

“…Ten articles (nine studies) reported on UI 25,26,29,33,34,41,48,49,52,53 ; five of these reported on UUI, 26,29,33,34,52 six on SUI, 25,26,29,33,34,41 and five on incontinence not otherwise specified. 29,41,48,49,53 Overall, the quality of evidence was moderate (Appendix 3, http://links.lww.com/AOG/D227).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies in five articles (one RCT 23,31,32 and one single-group study 33,34 ) reported on the full form of the UDI (Appendix 2, http://links.lww.com/AOG/ D227). There was a similar, significant improvement in UDI scores after both uterine artery embolization (n581) and hysterectomy (n575) for leiomyomas, and this improvement was maintained up to 60 months after intervention (mean change: uterine artery embolization 210.7; hysterectomy 28.4) but not at 120 months (mean change: uterine artery embolization 20.4; hysterectomy 3.2).…”

Section: Resultsmentioning

confidence: 99%

“…23,31,32 A significant improvement was also noted 4-6 years after surgical debulking (myomectomy or hysterectomy) (n530), with a median score change of 228.4 (interquartile range 258.8 to 20.9). 33,34 Six studies of moderate-to-high quality reported on change in IIQ-7 score after intervention, including one RCT and five single-arm studies (Appendix 2, http:// links.lww.com/AOG/D227) 23,[26][27][28][29][30] (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…41,48 In one single-group prospective study, only 4.4% of patients (3/68) reported urinary urgency 5 months after abdominal hysterectomy for leiomyomas, compared with 23.5% (16/68) before intervention. 41 Ten articles (nine studies) reported on UI 25,26,29,33,34,41,48,49,52,53 ; five of these reported on UUI, 26,29,33,34,52 six on SUI, 25,26,29,33,34,41 and five on incontinence not otherwise specified. 29,41,48,49,53 Overall, the quality of evidence was moderate (Appendix 3, http://links.lww.com/AOG/D227).…”

Section: Resultsmentioning

confidence: 99%

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Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Gupta

Balk

Lenger

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms. DATA SOURCES: PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans. METHODS OF STUDY SELECTION: Double independent screening for studies of any study design in all languages that reported pelvic floor symptoms before and after surgical (hysterectomy, myomectomy, radiofrequency volumetric thermal ablation) or radiologic (uterine artery embolization, magnetic resonance-guided focused ultrasonography, high-intensity focused ultrasonography) procedures for management of uterine leiomyomas. Data were extracted, with risk-of-bias assessment and review by a second researcher. Random effects model meta-analyses were conducted, as feasible. TABULATION, INTEGRATION, AND RESULTS: Six randomized controlled trials, one nonrandomized comparative study, and 25 single-group studies met criteria. The overall quality of the studies was moderate. Only six studies, reporting various outcomes, directly compared two procedures for leiomyomas. Across studies, leiomyoma procedures were associated with decreased symptom distress per the UDI-6 (Urinary Distress Inventory, Short Form) (summary mean change −18.7, 95% CI −25.9 to −11.5; six studies) and improved quality of life per the IIQ-7 (Incontinence Impact Questionnaire, Short Form) (summary mean change −10.7, 95% CI −15.8 to −5.6; six studies). There was a wide range of resolution of urinary symptoms after procedural interventions (7.6–100%), and this varied over time. Urinary symptoms improved in 19.0–87.5% of patients, and the definitions for improvement varied between studies. Bowel symptoms were inconsistently reported in the literature. CONCLUSION: Urinary symptoms improved after procedural interventions for uterine leiomyomas, although there is high heterogeneity among studies and few data on long-term outcomes or comparing different procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021272678.

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Section: Resultsmentioning

confidence: 99%