Cristina Cezar1, Sven Becker2, Attilio di Spiezio Sardo3, Anja Herrmann1, Angelika Larbig4, Vasilis Tanos5, Luz Angela Torres de la Roche6, Hugo Christian Verhoeven4, Markus Wallwiener7, Rudy Leon De Wilde8. 1. Clinic for Gynecology and Obstetrics of Carl von Ossietzky University Medical School, Oldenburg, Germany. 2. Clinic of Gynecology and Obstetrics at University Clinic Frankfurt, Frankfurt, Germany. 3. Clinic of Gynecology and Obstetrics at University of Naples Federico II, Naples, Italy. 4. Clinic for Gynecology, Obstetrics and Gynecological Oncology at Pius Hospital, University Hospital for Gynecology Carl von Ossietzky University Medical School, Georgstrasse 12, 26121, Oldenburg, Germany. 5. Surgery at Aretaeio Hospital and St Georges Medical School, Nicosia University, Nicosia, Cyprus. 6. Interinstitutional Group of Gynecology and Obstetrics-GIGyO at Department of Gynecology and Obstetrics, Universidad Libre of Cali, Cali, Colombia. 7. Clinic of Gynecology and Obstetrics and Gynecological Oncology at University of Heidelberg, Heidelberg, Germany. 8. Clinic for Gynecology, Obstetrics and Gynecological Oncology at Pius Hospital, University Hospital for Gynecology Carl von Ossietzky University Medical School, Georgstrasse 12, 26121, Oldenburg, Germany. rudy-leon.dewilde@pius-hospital.de.
Abstract
PURPOSE: Uterine myomas are the main cause of benign uterine diseases in premenopausal women. Objective of the present paper is to investigate the current best treatment modalities of myomas, depending on age of the patient and her desire to preserve fertility, as well as on clinical presentation of this pathology, such as size, number, and location of fibroids and, furthermore, on surgical experience of the gynecologist. METHODS: The design of our work is a systematic literature review of existing studies, reviews, and meta-analysis conducted in PubMed and Cochrane Library to identify relevant literature. Commonly, the myomectomy is to be recommended in women desiring to preserve fertility when myomas are associated with symptoms such as excessive bleeding, pelvic discomfort, or palpable abdominally fibroids. The decision of surgical approach for myomectomy should be individualized, depending on size and location, as well as on surgeon's experience. The different modalities of myomectomy, laparoscopic, hysteroscopic, robotic-assisted, or laparotomic are in detail presented in the paper, according to Society of Obstetricians and Gynecologists of Canada (SOGC) clinical practice guidelines and taking into consideration possible concerns of myomectomy such as uterine rupture, development of adhesions, and myomas' recurrence.
PURPOSE: Uterine myomas are the main cause of benign uterine diseases in premenopausal women. Objective of the present paper is to investigate the current best treatment modalities of myomas, depending on age of the patient and her desire to preserve fertility, as well as on clinical presentation of this pathology, such as size, number, and location of fibroids and, furthermore, on surgical experience of the gynecologist. METHODS: The design of our work is a systematic literature review of existing studies, reviews, and meta-analysis conducted in PubMed and Cochrane Library to identify relevant literature. Commonly, the myomectomy is to be recommended in women desiring to preserve fertility when myomas are associated with symptoms such as excessive bleeding, pelvic discomfort, or palpable abdominally fibroids. The decision of surgical approach for myomectomy should be individualized, depending on size and location, as well as on surgeon's experience. The different modalities of myomectomy, laparoscopic, hysteroscopic, robotic-assisted, or laparotomic are in detail presented in the paper, according to Society of Obstetricians and Gynecologists of Canada (SOGC) clinical practice guidelines and taking into consideration possible concerns of myomectomy such as uterine rupture, development of adhesions, and myomas' recurrence.
Authors: Ahmed El-Balat; Rudy Leon DeWilde; Iryna Schmeil; Morva Tahmasbi-Rad; Sandra Bogdanyova; Ali Fathi; Sven Becker Journal: Biomed Res Int Date: 2018-01-24 Impact factor: 3.411
Authors: Sa Ra Lee; Eun Sil Lee; Young Jae Lee; Shin Wha Lee; Jeong Yeol Park; Dae Yeon Kim; Sung Hoon Kim; Yong Man Kim; Dae Shik Suh; Young Tak Kim Journal: Yonsei Med J Date: 2020-12 Impact factor: 2.759