Literature DB >> 27651639

Clinicopathological Study of Uterine Leiomyomas: A Multicentric Study in Rural Population.

Maitri Raghavendra Kulkarni1, Indranil Dutta2, Dilip Kumar Dutta3.   

Abstract

BACKGROUND AND OBJECTIVES: Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs. This multicentric study was an attempt to analyze the clinicopathological spectrum in cases of leiomyoma of the uterus at Cheluvamba Hospital, Adichunchanagiri Institute of Medical Sciences, and to know regarding the pattern of presentation, pathological correlation, with type of fibroid, and endometrial and ovarian changes.
METHODS: A clinical study of 100 cases of fibroid uterus was conducted in the Cheluvamba Hospital, attached to Mysore Medical College and Research Institute, Mysore, and Adichunchanagiri Institute of medical sciences, BG Nagara, Mandya from November 2008 to August 2012. The cases are selected by random allocation. On admission, detailed history, clinical examination, and investigations were recorded.
RESULTS: Leiomyoma is the most common benign tumor of the uterus and commonly affects the women of child-bearing age, most commonly in the third decade, 55 %. The most common mode of presentation was menstrual disturbances (76 %), among which menorrhagia was seen in 54 % of the cases. Primary infertility was seen in 15 % of the patients. Intramural fibroids were the most common variety occurring in 60 % of the cases. Endometrial pattern was proliferative in 66.3 %. Cystic ovaries were seen in 8 % of the patients, adenomyosis in 16 % indicating hyperestrogenism.
CONCLUSION: Fibromyoma (leiomyoma) is the most common benign tumor of the pelvis. It commonly affects the women of child-bearing age, mostly in the third decade and is most commonly seen in multipara. The most common mode of presentation is menstrual disturbances. Intramural fibroid is the most common variety. The proliferative and hyperplastic endometrium was commonly reported. The presence of proliferative endometrium, adenomyosis, and cystic ovaries all are indicative of hyperestrogenic state associated with development of fibroids.

Entities:  

Keywords:  Fibroid; GnRH analogs; Hysterectomy; Leiomyoma; Menorrhagia; Myomectomy; Uterine artery embolization

Year:  2015        PMID: 27651639      PMCID: PMC5016411          DOI: 10.1007/s13224-015-0773-y

Source DB:  PubMed          Journal:  J Obstet Gynaecol India        ISSN: 0975-6434


  10 in total

1.  Uterine fibroids: uterine artery embolization versus abdominal hysterectomy for treatment--a prospective, randomized, and controlled clinical trial.

Authors:  Isabel Pinto; Paloma Chimeno; Alicia Romo; Laura Paúl; Javier Haya; Miguel A de la Cal; José Bajo
Journal:  Radiology       Date:  2003-02       Impact factor: 11.105

2.  Arterial embolisation to treat uterine myomata.

Authors:  J H Ravina; D Herbreteau; N Ciraru-Vigneron; J M Bouret; E Houdart; A Aymard; J J Merland
Journal:  Lancet       Date:  1995-09-09       Impact factor: 79.321

3.  Variation in the incidence of uterine leiomyoma among premenopausal women by age and race.

Authors:  L M Marshall; D Spiegelman; R L Barbieri; M B Goldman; J E Manson; G A Colditz; W C Willett; D J Hunter
Journal:  Obstet Gynecol       Date:  1997-12       Impact factor: 7.661

4.  Magnetic resonance-guided focused ultrasound surgery.

Authors:  Mariam M Al Hilli; Elizabeth A Stewart
Journal:  Semin Reprod Med       Date:  2010-04-22       Impact factor: 1.303

5.  Laparoscopic radiofrequency thermal ablation: a new approach to symptomatic uterine myomas.

Authors:  Valentino Bergamini; Fabio Ghezzi; Antonella Cromi; Gaia Bellini; Giovanni Zanconato; Stefano Scarperi; Massimo Franchi
Journal:  Am J Obstet Gynecol       Date:  2005-03       Impact factor: 8.661

6.  Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case--control study.

Authors:  P Lumbiganon; S Rugpao; S Phandhu-fung; M Laopaiboon; N Vudhikamraksa; Y Werawatakul
Journal:  Br J Obstet Gynaecol       Date:  1996-09

7.  The effects of RU 486 and leuprolide acetate on uterine artery blood flow in the fibroid uterus: a prospective, randomized study.

Authors:  R C Reinsch; A A Murphy; A J Morales; S S Yen
Journal:  Am J Obstet Gynecol       Date:  1994-06       Impact factor: 8.661

8.  Laparoscopically assisted uterine fibroid cryoablation.

Authors:  Moty Pansky; Bryan D Cowan; Maya Frank; Harriette L Hampton; Stephen Zimberg
Journal:  Am J Obstet Gynecol       Date:  2009-08-29       Impact factor: 8.661

9.  Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up.

Authors:  K Funaki; H Fukunishi; K Sawada
Journal:  Ultrasound Obstet Gynecol       Date:  2009-11       Impact factor: 7.299

10.  Directed laparoscopic cryomyolysis: a possible alternative to myomectomy and/or hysterectomy for symptomatic leiomyomas.

Authors:  Errico Zupi; Alessio Piredda; Daniela Marconi; Duane Townsend; Caterina Exacoustos; Domenico Arduini; Beata Szabolcs
Journal:  Am J Obstet Gynecol       Date:  2004-03       Impact factor: 8.661

  10 in total

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