Uterine fibroid vascularization: from morphological evidence to clinical implications

Ciarmela, Pasquapina; Carpini, Giovanni Delli; Greco, Stefania; Zannotti, Alessandro; Montik, Nina; Giannella, Luca; Giuliani, Lucia; Grelloni, Camilla; Panfoli, Francesca; Paolucci, Michela; G, Pierucci; Ragno, Federica; Pellegrino, Pamela; Ciavattini, Andrea

doi:10.1016/j.rbmo.2021.09.005

Cited by 17 publications

(7 citation statements)

References 101 publications

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“…When evaluated by TVUS in infertile young endometriotic patients [8], the coexistence of uterine fibroids and endometriosis was found only in 3.1% of cases. The concomitance of endometriosis and uterine fibroids can determine a synergic negative effect on abnormal uterine bleeding (AUB), HMB, dysmenorrhea, chronic pelvic pain, or infertility, affecting global QoL [13,[37][38][39].…”

Section: Uterine Fibroidsmentioning

confidence: 99%

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Capezzuoli¹,

Orlandi²,

Clemenza³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Objectives:Endometriosis is an inflammatory disease characterized by a frequent association with gynecologic and systemic comorbidities. Our aim was to evaluate which gynecologic and systemic comorbidities occur in women affected by endometriosis and their impact on quality of life and global health. Mechanism: A literature search of the PubMed, Cochrane Library, Scopus and Web of Science databases was performed to identify the relevant studies published before December 31, 2021. We selected clinical studies, systematic reviews, and meta-analyses in English. Findings in Brief: Endometriosis is strongly associated with gynecologic (adenomyosis, uterine fibroids, polycystic ovarian syndrome-PCOS) and systemic (autoimmune, inflammatory, psychiatric and neurological disorders) comorbidities that impair women quality of life and global health through multiple mechanisms, influencing everyday life and work activities. Conclusions: Endometriosis is a chronic disease, impairing multiple functioning areas and affecting women's health and everyday life. Considering the co-existence of multiple both gynecological and non-gynecological disorders, endometrisois needs a multidisciplinary approach. Thus, specialized referral centres are warranted for a personalized management, focused on patient symptoms and comorbidities.

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Section: Uterine Fibroidsmentioning

confidence: 99%

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Capezzuoli¹,

Orlandi²,

Clemenza³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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“…UFs are the most common benign tumors of the reproductive system in women, and their prevalence is as high as 20–30% in fertile women ( 16 ), with an incidence of 40% in women at the age of 35 years that can approach 70–80% by the age of menopause ( 17 ). Despite their high prevalence, up to 70% of fibroids are asymptomatic and thus do not require frequent follow-up or medical intervention ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for postoperative bleeding and recurrence after laparoscopic myomectomy in patients with uterine fibroids: a retrospective cohort study

Han¹,

Su²,

Shang³

et al. 2023

Gland Surg

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Background: In Asia, the incidence of uterine fibroids (UFs) in women is as high as 1.278%. However, there are few analyses of the prevalence and independent risk factors for bleeding and recurrence after laparoscopic myomectomy (LM). This study aimed to analyze the clinical characteristics of patients with UF and identify the independent risk factors for postoperative bleeding and recurrence after LM, so as to provide a reference basis for improving the quality of life of patients. Methods: Based on our exclusion and inclusion criteria, we retrospectively analyzed a total of 621 patients who developed UF from April 2018 to June 2021. The t-test, analysis of variance (ANOVA), and chisquare test were used to analyze the relationship between the clinical characteristics of the patients and postoperative bleeding as well as recurrence. Binary logistic regression was used to analyze the independent risk factors for the occurrence of postoperative bleeding and fibroid recurrence in patients. Results: The rates of postoperative bleeding and recurrence after LM for uterine fibroids were 4.5% and 7.1%, respectively. Binary logistic regression analysis showed that fibroid size [odds ratio (OR) =5.502, P=0.003], maximum fibroid type (OR =0.293, P=0.048), pathological type (OR =3.673, P=0.013), preoperative prothrombin time level (OR =1.340, P=0.003), preoperative hemoglobin level (OR =0.227, P=0.036), surgery time (OR =1.066, P=0.022), intraoperative bleeding (OR =1.145, P=0.007), and postoperative infection (OR =9.540, P=0.010) were independent risk factors for postoperative bleeding; meanwhile, body mass index (BMI) (OR =1.268, P=0.001), age of menarche (OR =0.780, P=0.013), fibroid size (OR =4.519, P=0.000), fibroid number (OR =2.381, P=0.033), maximum fibroid type (OR =0.229, P=0.001), pathological type (OR =2.963, P=0.008), preoperative delivery (OR =3.822, P=0.003), preoperative C-reactive protein (CRP) level (OR =1.162, P=0.005), intraoperative ultrasonography (OR =0.271, P=0.002), postoperative gonadotropin-releasing hormone agonist treatment (OR =2.407, P=0.029), and postoperative infection (OR =7.402, P=0.005) were independent risk factors for recurrence. Conclusions: At present, there is still a high probability of postoperative bleeding and recurrence after LM for UF. Clinical work should pay close attention to clinical features. Adequate preoperative examination to improve surgical precision, and strengthen postoperative care and education, thus reducing the probability of postoperative bleeding and recurrence in patients.

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“…Uterine myomas are heterogeneous tumors by number, size, location, and vascularization. Their numerous associated symptoms -such as bleeding, anemia, pressure on the bladder, and fertility disorders -seriously affect women's health [4,30,31]. Numerous factors and molecular signaling pathways have been studied for many years, suggesting therapeutic alternatives to surgery [3,5,8,32].…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Expression of the ANGPT1, Casr and PTK2 Proteins in Uterine Fibroids

Markowska,

De Mezer,

Kurzawa

et al. 2023

Preprint

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Understanding the molecular factors involved in the development of uterine myomas may result in the use of pharmacological drugs instead of aggressive surgical treatment. ANGPT1, CASR, and PTK2 were examined in myoma and peripheral tissues samples taken from women after myoma surgery and in normal uterine muscle tissue samples in the control group. Tests were performed using tissue microarray immunohistochemistry. No statistically significant differences in ANGPT1 expression between the tissue of the myoma, the periphery, and the normal uterine muscle tissue of the control group were recorded. The CASR value was reduced in the myoma and peripheral tissue and normal in the group of women without myomas. PTK2 expression was also lower in the myoma and periphery com-pared to healthy uterine myometrium. Calcium supplementation could have an effect on stop-ping the growth of myomas.

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Uterine fibroid vascularization: from morphological evidence to clinical implications

Cited by 17 publications

References 101 publications

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Analysis of risk factors for postoperative bleeding and recurrence after laparoscopic myomectomy in patients with uterine fibroids: a retrospective cohort study

Immunohistochemical Expression of the ANGPT1, Casr and PTK2 Proteins in Uterine Fibroids

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