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A Five-Year Survey of Uterine fibroids at a Nigerian Tertiary Hospital

Open Journal of Obstetrics and Gynecology 2018年第5期8卷 468-476页

作者： A. D. Isah N. Adewole E. T. Agida K. I. Omonua Department of Obstetrics and Gynaecology University of Abuja Teaching Hospital Abuja Nigeria

Introduction: Uterine leiomyomas, commonly called fibroids are benign tumors of uterine myometrium composing of smooth muscle with variable amount of connective tissue and common gynecological problem among women of reproductive age. It is the commonest tumor of the female pelvic organ. Objective: To determine the incidence of uterine fibroids, socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Material and Methods: This is a retrospective descriptive analysis of all the uterine fibroids carried out at the University of Abuja Teaching Hospital, Gwagwalada from 4th January 2013 to 31st December 2017. Data were obtained from medical records, gynaecological ward and theatre records of University of Abuja Teaching Hospital. Data were analyzed using socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Results were presented using simple percentages and ratios. Results: Uterine fibroids accounted for 6.4% of all gynaecological admissions and 21. 3% of all major gynaecological surgeries. Uterine fibroid was found to be common between the age range 30 - 39 (47.5%) years, followed by 20 - 29 (26.3%) and 40 - 49 (15.7%) years. One hundred and twenty-two (61.7%) were nulliparous while 48 (24.2%) were primiparous. Majority of the women 88 (44.4%) had tertiary education, 49 (24.7%) secondary, 48 (24.3%) primary and 13 (6.6%) had no formal education. Seventy-six (38.4%) presented with menorrhagia, abdominal mass 71 (35.9%), infertility 68 (34.3%) and abdominal pain 48 (24.2%). Most of the patients had multiple fibroids, 81 (40.9%) had intramural, 70 (35.4%) submucous and 52 (26.3%) subserous. Out of 198, 165 (83.3%) had myomectomy, 23 (11.6%) had total abdominal hysterectomy and 9 (4.6%) myomectomy and tuboplasty. Anaemia 41 (20.7%) was the commonest morbidity, followed by wound infection 12 (6.1%) and wound dehiscence 4 (2.0%). No mortality was recorded during the period under review. Conclusion: Uterine f

关键词： Uterine fibroids Incidence Presentation Outcome

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Percutaneous Ultrasound-Guided Radiofrequency Thermal Ablation for Treatment of Uterine fibroids

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Open Journal of Obstetrics and Gynecology 2014年第12期4卷 716-724页

作者： Raúl García Marcos Javier Monleón Alicia Martínez-Varea Fernando Gómez Guillermina Montoliú Jose J. Martínez Luis Martí-Bonmatí Antonio Pellicer Department Obstetrics and Gynecology La Fe University Hospital Valencia Spain Department of Radiology Hospital Clinic Barcelona Spain Department of Radiology La Fe University Hospital Valencia Spain

Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic uterine fibroids despite conventional medical treatment were included. The assessment of symptoms and characteristics of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) was performed before starting treatment and 6 months after the procedure. Successful treatment was clinically considered if patients reported a reduction in symptoms 6 months after RF myolysis. Successful treatment was also considered if the necrosis of the fibroid was greater than 50%, 6 months after treatment. Results: The baseline score on visual analogue scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ± 3.4, respectively. According to a score of 0 - 3, baseline bleeding during menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p = 0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17 patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI monitoring 6 months post-myolysis. Compared to baseline fibroid volume, ultrasound and MRI volume were 57.38% and 79.66% six months after surgery, respectively. A total of 13 patients (92.86%) had radiological success from the treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis reduces volume and symptoms of uterine fibroids, it may be considered as a valid treatment for symptomatic fibroids.

关键词： Percutaneous Radiofrequency Thermal Ablation Myolysis Uterine fibroids

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Effect of Modified and accumulated decoction on serum ER, PR, sex hormone, IGF-I and IGF-I in patients with uterine fibroids

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Journal of Hainan Medical University 2017年第21期23卷 50-54页

作者： Yi-Sha Li Lu Chen Dan Liu Gynaecology Huangshi city Hospital of Traditional Chinese Medicine(Infectious Disease Hospital)Edong Healthcare GroupHuangshi435000China Obstetrics and Gynecology Department Affiliated Hospital of Jianghan University(Wuhan Sixth Hospital)Wuhan430015China

Objective: To study the effect of Modified and accumulated Decoction on serum ER, PR, sex hormone, IGF-I and IGF-I in patients with uterine fibroids. Method: A total of 90 patients with uterine fibroids in our hospital from January 2015 to January 2017 were enrolled in this study. The subjects were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group was treated with mifepristone, the treatment group was treated with Modified and accumulated Decoction combined with mifepristone, and both the two groups were treated for 3 months. The uterine fibroid volume and uterine volume of the two groups before and after treatment were compared. The serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups before and after treatment were compared. Result: There were no significantly differences of the uterine fibroid volume and uterine volume of the two groups before treatment. The uterine fibroid volume and uterine volume of the two groups after treatment were significantly less than before treatment, and that of the treatment group after treatment were significantly less than the control group. There were no significantly differences among the serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups before treatment. The serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly lower than the control group. Conclusion: Modified and accumulated Decoction combined with mifepristonecan significantly reduce the uterine fibroid volume, improve the serum ER, PR, sex hormone, IGF-I and IGF-I levels of the patients with uterine fibroids, and it was worthy clinical application.

关键词： Modified and accumulated Decoction Mifepristone Uterine fibroids ER PR Sex hormone IGF-I

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Efficacy of Carboprost Tromethamine Combined with Mifepristone in the Treatment of Uterine fibroids

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Journal of Clinical and Nursing Research 2019年第1期3卷 3-6页

作者： Jun Wang Xian Zhang Zhucheng People’s Hospital Zhucheng CityWeifang CityShandong Province

The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as *** to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 *** oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation *** treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor *** clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant ***,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control *** progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further *** tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.

关键词： carboprost tromethamine mifepristone uterine fibroids clinical efficacy

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The Intrauterine Bigatti Shaver for Endometrial Lesions: Our Experience and Modifications

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Open Journal of Obstetrics and Gynecology 2017年第1期7卷 1-6页

作者： Liying Yang Hemashree Rajesh Suling Yu Department of Obstetrics & Gynaecology Singapore General Hospital Singapore City Singapore

Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.

关键词： Endometrial Polyps Submucosal fibroids Intrauterine Bigatti Shaver Hysteroscopic Surgery

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Hysterosalpingographic Findings among Patients Undergoing Infertility Work-Up in Kisangani, Democratic Republic of the Congo

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 267-277页

作者： Jean-Didier Bosenge Nguma Antoine Modia O’yandjo Jeanot Juakali Sialikyolo Gaston Litalema Liogo Antoine Molua Aundu Roger Amisi Kitoko Gédeon Katenga Bosunga Department of Gynecology-Obstetrics Faculty of Medicine and Pharmacy University of Kisangani Kisangani DRC Department of Medical Imaging Radiology Unit Kisangani University Hospital Kisangani DRC Department of Medical Imaging Unit of Imaging of Women University of Kinshasa Kinshasa DRC Department of Surgery Faculty of Medicine and Pharmacy University of Kisangani Kisangani DRC

Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for performing first-line anatomical (pelvic) assessment. The aim of this study is to determine the prevalence of the different lesions observed in hysterosalpingography carried out during the assessment of infertile women monitored in Kisangani. The study set also out to look for differences in these lesions according to the type of infertility. Methods: This cross-sectional study was conducted in Kisangani from June 2016 to December 2018. The 130 cases of hysterosalpingography performed for female infertility assessment during the study period were included, of which 33.07% for primary infertility and 66.93% for secondary infertility. Results: The mean age of the patients was 33.52 ± 6.01 years;the history of pelvic inflammatory disease was noted with a predominance for secondary infertility (11% vs. 4.65%). Using hysterosalpingography, 7 (5.38%) patients had a normal result;94 (72.31%) had tubal obstruction;25 (19.23%) had hydrosalpinx;11 (8.46%) had uterine fibroids;pelvic adhesions were suspected in 12.64% of cases. There was no obvious association between all these lesions and the type of infertility. Conclusion: We found that tubal obstructions were the most prevalent lesions in this study, regardless of the type of infertility. These lesions would reflect the high prevalence of septic abortions and sexually transmitted infections in developing countries such as the Democratic Republic of the Congo.

关键词： Hysterosalpingography Female Infertility Tubal Obstruction Hydrosalpinx Pelvic Adhesion Uterine fibroids

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Myoma Delivered through the Cervical during Labor: About a Case and Review of the Literature

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 97-102页

作者： Touré Écra Ana Konan Blé Rémy Marcel N’Cho Edi Koffi Koffi Abdoul Aka Edel Konan Perel Olou Luc Université Félix Houphouë t Boigny Abidjan C&ocirc te d’Ivoire Hô pital Général de Yopougon Attié Abidjan C&ocirc te d’Ivoire

The authors report the clinical case of a multipara whose intracervical myoma had been diagnosed during the prenatal follow-up and who was delivered into the vagina during labor. Caesarean section was indicated to avoid rupture of the pedicle during fetal expulsion. The myomectomy was performed in a second operation via the vagina, without complications.

关键词： fibroids Pregnancy Childbirth Location

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Case Report: Parasitic Leiomyoma

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Journal of Cancer Therapy 2019年第9期10卷 722-726页

作者： G. Yared J. Darido R. Chahine J. Khadra R. Bachnak R. Bou Ghanem K. Dimashkie M. Kharroubi I. Farhat I. Hatoum Department of Obstetrics and Gynecology Rafic Hariri University Hospital Beirut Lebanon Department of Obstetrics and Gynecology The Lebanese University Beirut Lebanon Department of Urology Surgery Rafic Hariri University Hospital Beirut Lebanon

Parasitic Leiomyoma (PL) is considered a rare variant of uterine fibroids occurring outside the uterus. We hereby report a challenging case of parasitic leiomyoma that is considered rare in the literature with all its particularities. A 62 YO lady is known to have a history of diabetes, right breast carcinoma, appendectomy and normal vaginal deliveries presenting with a two-year history of back and abdominal pain with recent urinary symptoms. Therefore, an abdominopelvic Ct scan and MRI were done showing uterine fibroids compressing the bladder. The patient underwent an exploratory laparotomy. A palpable intravesical mass was identified. Transurethral cystoscopic resection was performed. Pathology results confirmed the leiomyomatous nature of the mass. Postoperatively, the surgery was complicated with a wound dehiscence and a hematoma formation on the left lateral wall of the bladder that was treated conservatively with a good follow-up outcome.

关键词： Parasitic Leiomyoma Uterine fibroids

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Aberrant Right Ovarian Artery from Proximal Internal Iliac Artery in Uterine Artery Embolization Patient

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Open Journal of Radiology 2012年第4期2卷 117-119页

作者： Richard A. Reed Bruce McLucas Department of Obstetrics and Gynecology David Geffen School of Medicine at the University of California Los Angeles USA Department of Radiology Huntington Memorial Hospital Pasadena USA

Some patients who undergo Uterine Artery Embolization (UAE) for symptomatic leiomyomata have collateral ovarian artery supply to the uterus. This typically occurs when the ipsilateral uterine artery is small or absent, and the ovarian artery supply to the uterus can lead to UAE failure. The authors present a case of a woman treated with UAE who had an atretic right uterine artery and an enlarged right ovarian artery supplying the fibroids. The ovarian artery arose from the proximal internal iliac artery. This rare variant vessel was embolized leading to eradication of the patient’s symptoms. The success of this case highlights the need to evaluate for possible variant ovarian artery supply and to embolize these vessels in an attempt to prevent UAE failure.

关键词： Uterine Artery Embolization fibroids Minimally Invasive

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Spontaneous Uterine Rupture during Late Pregnancy after High-intensity Focused Ultrasound

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Chinese Medical Journal 2015年第10期128卷 1419-1419页

作者： Xiao-Wei Li Mei-Ying Liang Jian-Liu Wang Da-Peng Wang Department of Obstetrics and Gynecology People's Hospital of Peking University Beijing 100044 China

To the Editor： Uterine rupture after high-intensity focused ultrasound （HIFU） is rare and has not been reported previously. A 32-year-old primigravida at 38 weeks of gestation was admitted to the hospital with the complaints of abdominal pain but denied trauma. Her medical history revealed that an HIFU had been conducted 20 months before pregnancy, 8.2 cm in diameter, located in anterior uterine wall. A cesarean section was performed to deliver the baby after severe variable deceleration of the fetal heart rate, and a complete spontaneous uterine rupture was discovered which was 10 cm long and located at the previous scar. After positive rescue, both the patient and the fetus recovered well.

关键词： fibroids

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