“…It's estimated that 70–80% of women will be affected by them at some point in their lives and vast majority of those cases will show no symptoms at all ( Don et al, 2022 ). Abnormal bleeding, pelvic discomfort, menorrhagia, infertility, miscarriages, and other obstetric difficulties are all clinical indications of UF that contribute to poor quality of life ( Keizer et al, 2022 , Piriyev and Römer, 2023 ; Yudha Pratama Putra et al, 2021 ). Fig.…”
“…It's estimated that 70–80% of women will be affected by them at some point in their lives and vast majority of those cases will show no symptoms at all ( Don et al, 2022 ). Abnormal bleeding, pelvic discomfort, menorrhagia, infertility, miscarriages, and other obstetric difficulties are all clinical indications of UF that contribute to poor quality of life ( Keizer et al, 2022 , Piriyev and Römer, 2023 ; Yudha Pratama Putra et al, 2021 ). Fig.…”
“…In 2022, a total of 126 patients with uterine submucosal fibroids were enrolled by Keizer et al, among which 104 patients underwent TCRM. At the 6‐month postoperative follow‐up, the Pictorial Blood Assessment Chart, hemoglobin level, symptoms of uterine fibroids, and UFS and QoL scores showed significant improvement 14 …”
Section: Discussionmentioning
confidence: 97%
“…At the 6-month postoperative follow-up, the Pictorial Blood Assessment Chart, hemoglobin level, symptoms of uterine fibroids, and UFS and QoL scores showed significant improvement. 14 This study compared the baseline UFS scores at the postoperative 3, 6, and 12 months follow-up In the TCRM group, the baseline UFS was 30. 75.4 ± 4.6 at 3 months.…”
Section: Guidelines Of the International Society Of Gynecologicalmentioning
Objectives
To compare the efficacy and safety of percutaneous microwave ablation (PMWA) and transcervical resection of myoma (TCRM) for submucosal fibroids.
Methods
From January 2019 to January 2021, we conducted a randomized controlled study involving patients with symptomatic uterine submucosal fibroids. Questionnaires were also used to measure the uterine fibroid symptom (UFS) scores and quality of life (QoL) scores before and after treatment at 3, 6, and 12 months. Outcomes, adverse events, hemoglobin recovery, and submucosal fibroid volume of both groups were also compared. Operation time, amount of bleeding, hospital stay time, and occurrence of complications were compared in groups with fibroids of different lengths.
Results
Follow‐up after surgery showed that UFS scores at 3, 6, and 12 months were significantly lower in each group, while QoL scores increased significantly. For fibroids less than 3 cm, surgical time was 34.2 ± 9.9 min, incidence of perioperative complications was 4.2%, and both decreased significantly, compared to the surgical time of the PMWA group (40.0 ± 8.1 min) and incidence of perioperative complications (24%; p < .05 for both). For uterine submucosal fibroids >5 cm, the operation time in the PMWA group was 92.7 ± 16.0 min, intraoperative bleeding volume was 22.7 ± 6.4 mL, and hospital stay was 2.7 ± 1.1 days, which were significantly less than the procedural time (107 ± 11.9 min), intraoperative bleeding loss (45.9 ± 12.8 mL), and length of hospital stay (5.0 ± 1.1 days) in the TCRM group. The differences were statistically significant (p < .05).
Conclusions
PMWA and TCRM were both effective treatments for uterine submucosal fibroids. For fibroids shorter than 3 cm in length, especially pedicled submucosal fibroids, TCRM has absolute advantages; however, for uterine submucosal fibroids >5 cm, PMWA avoids perioperative complications, such as uterine perforation, water poisoning syndrome, and the need for repeat surgery, and is considered the preferred mode of treatment. Therefore, personalized treatment should be used for different patients with uterine submucosal fibroids.
“…After the evaluation of the full text, 12 studies were excluded [23][24][25][26][27][28][29][30][31][32][33][34] ; three studies [35][36][37] were included in the present meta-analysis (Figure 1).…”
BackgroundThe effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain.ObjectivesTo evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic review and meta‐analysis (CRD42022379700).Search strategyElectronic databases were searched until November 15, 2022.Selection criteriaStudies evaluating the effects of FIGO type 3 myomas on IVF outcome.Data collection and analysisPooled results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using Higgins I2. Sources of heterogeneity were explored with sensitivity and subgroup analyses.Main resultsIn total, 1020 patients were included: 324 with FIGO type 3 myomas and 696 controls (without myomas). A pooled data analysis showed a significantly lower live birth rate (OR 2.16, 95% CI 1.55–3.01, I2 = 0%, P < 0.00001), clinical pregnancy rate (OR 2.06, 95% CI 1.52–2.81, I2 = 0%, P < 0.00001), and implantation rate (OR 1.77, 95% CI 1.35–2.32, I2 = 0%, P < 0.00001) in women with untreated myomas compared with controls. The number and size of fibroids correlated with a worsening of IVF outcomes.ConclusionsFIGO type 3 myomas are significantly associated with a lower implantation rate, cumulative pregnancy rate, and live birth rate. Furthermore, their deleterious effect on the outcome of IVF increases further with increasing size and number. Nevertheless, no firm conclusions could be drawn about the potential benefits of surgery for FIGO type 3 uterine fibroids on IVF outcomes.
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