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Advances in Treatment of myoma of Uterus

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Medicinal Plant 2018年第6期9卷 97-100页

作者： Xiaohua DUAN Maomao ZHANG Jinglin HE Deqiang FENG Yunnan University of Traditional Chinese Medicine

myoma of uterus has the highest incidence in gynecological *** incidence rate is increasing year by year,which is the main indication for ***-surgical treatment is often adopted for young patients with fertility *** t... 详细信息

关键词： myoma of uterus Minimally invasive treatment Drug therapy

Effectiveness of microwave endometrial ablation combined with hysteroscopic transcervical resection in treating submucous uterine myomas

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World Journal of Clinical Cases 2022年第36期10卷 13200-13207页

作者： Toshiyuki Kakinuma Kaoru Kakinuma Ayano Shimizu Ayaka Kaneko Masataka Kagimoto Takafumi Okusa Eri Suizu Koyomi Saito Yoshio Matsuda Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada Department of Obstetrics and Gynecology International University of Health and Welfare HospitalNasushiobara 329-2763Japan

BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday *** condition can restrict women’s social activities and decrease their quality of *** endometrial ablation(MEA)using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment,triggered by systemic disease or medications,or caused by uterine myomas and *** popularity of MEA has increased *** MEA can safely and effectively treat submucous myomas,some patients may still experience recurrent hypermenorrhea postoperatively and may require additional *** To investigate the efficacy of MEA combined with transcervical resection(TCR).METHODS Participants underwent cervical and endometrial *** resonance imaging and hysteroscopy were performed to evaluate the size and location of the *** was performed before MEA using a *** was performed using transabdominal *** variables included operation time,number of ablation cycles,length of hospital stay,and visual analog scale cores for hypermenorrhea,dysmenorrhea,and treatment satisfaction at 3 and 6 mo *** postoperative incidence of amenorrhea,changes in hemoglobin concentrations,and MEA-related complications were *** A total of 34 women underwent a combination of MEA and TCR during the study *** patients were excluded from the study as their histopathological tests identified uterine malignancies(uterine sarcoma and endometrial cancer).The 32 eligible women(6 nulliparous,26 multiparous)had a mean age of 45.2±4.3 years(range:36–52 years).Patients reported very severe hypermenorrhea(10/10 points on the visual analog scale)before the ***,after the procedure,the hypermenorrhea scores decreased to 1.2±1.3 and 0.9±1.3 at 3 and 6 mo,respectively(P<0.001)

关键词： Dysmenorrhea Endometrial ablation techniques Menorrhagia Microwaves myoma Uterus

Effect of Lichong decoction on expression of Bcl-2 and Bcl-2-associated X protein mRNAs in hysteromyoma model rat

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Journal of Traditional Chinese Medicine 2013年第2期33卷 238-242页

作者： Donghua Li Xin Xu Ruiya Qian Jianguo Geng Yan Zhang Xiaolei Xie Yasong Wang Xiaoli Zou School of Traditional Chinese Medicine Capital Medical University Beijing Hospital ofTraditional Chinese Medicine Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing Maternaland Child Health Care Hospital Beijing 100026China

OBJECTIVE:To study on effects of Lichong decoction on expression of apoptosis-controlling genes,Bcl-2 and Bcl-2-associated X protein(Bax) mRNAs in hysteromyoma tissue of the hysteromyoma model ***:Fifty Wistar female rats were randomly divided into a normal group,a model group,a Lichong decoction group,a Guizifuling capsule group and a Mifepristone *** hysteromyoma rat model was established by intraperitoneal injection of exogenous estrin and *** examination of uterine tissue,uterine coefficient and uterine transverse diameter were made under optic microscope and expressions of Bcl-2 and Bax mRNAs in uterine tissue in the groups were detected with real-time fluorescent quantitative polymerase chain reaction(PCR) ***:After treatment,under microscope it was found that in the Lichong decoction group myometrium thinned,muscle fiber slightly overgrowth or long and thin,regular arrangement,inserting phenomenon of inner circular muscle and external longitudinal muscle was occasionally or not seen in the Lichong decoction *** uterine coefficient and the uterine transverse diameter significantly decreased(Pmyoma tissue(Pmyoma is related with decrease of Bcl-2 mRNA expression and increase of Bax mRNA expression.

关键词： myoma Apoptosis Genes, bcl-2 Bcl-2-associated X protein Lichong decoction

Improved Fertility Following Enucleation of Intramural myomas in Infertile Women

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Chinese Medical Journal 2017年第14期130卷 1648-1653页

作者： Yu-Cui Tian Jian-Hong Wu Hong-Mei Wang Yin-Mei Dai Department of Perinatal Medicine Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China Department of Gynecology Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China Department of Minimal Invasive Gynecology Center Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China

Background：The relationship between intramural myomas and fertility remains *** main debate rests on whether cavity-distorting intramural lnyomas （CDMs） adversely affect fertility more than *** aimed to compare the effects ofenucleating non-CDMs and CDMs on fertility improvement in females with unexplained ***：We prospectively recruited 83 women undergoing myomectomy for unexplained infertility with intramural myomas between June 2008 and November 2012 and classified them into non-CDMs group （n =45） and CDMs group （n =38）.We then compared postoperative infertility rates,spontaneous pregnancy rates,pregnancy outcomes,live birth rates,and obstetric *** continuous variables,we calculated the mean ± standard deviation,median and interquartile range,and analyzed the data using Student＇s t-test and the Mann-Whitney *** categorical variables,the Pearson＇s Chi-square test,the continuity correction test,and Fisher＇s exact test were ***：Patients＇ demographics and myoma characteristics were comparable between the two *** overall spontaneous pregnancy rate increased from 0% to 68.42% following *** postoperative infertility rate was significantly higher in the non-CDMs group than that in the CDMs group （50.00% vs.23.53%,t =5.579,P =0.018）,whereas the postoperative spontaneous pregnancy rate was significantly lower in the non-CDMs group than that in the CDMs group （47.62% vs.70.59%,t 4.067,P =0.044）.Compared with the enucleation ofnon-CDM,the enucleation of CDM patients was a protective factor for the fertility restoration （risk ratio [RR] =3.717,95% confidence interval [CI]：1.284-10.753,P =0.015）,although postoperative fertility restoration declined with age （RR =1.141,95% CI：1.005-1.295,P =0.041）.Conclusions：Intramural myomas are associated with impaired *** experiencing unexplained infertility,and possessing intramural myomas,have a better chance of conception following myomectomy,and t

关键词： Infertility myoma Pregnancy Outcome Uterine Myomectomy

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Piloleiomyoma

International Journal of Dermatology and Venereology 2021年第2期4卷 131-132页

作者： Zhen-Zhen Yan Xin Sun Ming Zhang Jian-Min Chang Yan-Qing Gao Department of Dermatology Capital Medical University You An HospitalBeijing 100069China Department of Dermatology Beijing HospitalNational Center of GerontologyBeijing 100730China

Histopathology Cutaneous piloleiomyoma(PLM),angioleiomyoma,and genital leiomyoma are variants of superficial cutaneous leiomyoma(CL).The classic appearance of a CL on hematoxylin and eosin staining is an unencapsulated,circumscribed dermal tumor composed of interlacing fascicles of spindle cells with a moderate amount of eosinophilic cytoplasm and a blunt-ended,elongated,cigar-shaped nucleus with perinuclear halos on crosssection;there is sometimes nuclear pleomorphism or a small number of mitoses,but the tumor retains its benign character(Fig.1A).

关键词： superficial shaped myoma

Laparoscopic hysterectomy as optimal approach for 5400 grams uterus with associated polycythemia: A case report

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World Journal of Clinical Cases 2019年第19期7卷 3027-3032页

作者： Antonio Macciò Giacomo Chiappe Fabrizio Lavra Elisabetta Sanna Romualdo Nieddu Clelia Madeddu Department of Gynecologic Oncology Azienda Ospedaliera BrotzuCagliari 09100Italy Department of Medical Sciences and Public Health Medical Oncology UnitUniversity of CagliariCagliari 09042Italy

BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is *** is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and *** we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated *** SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous *** suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several *** analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of *** blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 *** computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 *** reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic *** uterus weighed 5400 g and the histology confirmed a diagnosis of *** did not find increased erythropoietin levels in the supernatant of the myomatous uterine *** were no *** postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,*** blood gas analysis after surgery showed a pO2 of 144.7 *** results suggested the diagnosis of myomatous erythrocytosis *** patient was discharged on the second postoperative day in very good condition with no *** We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and *** VTE risk factors warranted a laparoscopic approach.

关键词： Hysterectomy Laparoscopy myoma myomatous erythrocytosis syndrome Polycythemia,huge uterus Total laparoscopic hysterectomy Case report

Contribution of the Tourniquet in the Prevention of Haemorrhages during Myomectomies at the University Hospital of Brazzaville

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Open Journal of Obstetrics and Gynecology 2018年第8期8卷 701-706页

作者： C. Itoua E. M. L. Eouani F. S. Okoko Ambeto N. S. B. Potokoué Mpia N. S. B. Potokoué Mpia P. S. Koko F. O. Atipo-Tsiba Galiba L. H. Iloki Obstetrics Gynaecology Department University Hospital of Brazzaville Brazzaville Congo Obstetrics Gynaecology Department Loandjili General Hospital Pointe Noire Congo Clinical Haematology Department University Hospital Brazzaville Brazzaville Congo

Objective: To check the effectiveness of tourniquet in the prevention of haemorrhage during myomectomies at the University Hospital of Brazzaville. Patients and methods: Analytical cross-sectional study, conducted at the University Hospital of Brazzaville from June 1, 2014 to June 30, 2016. Recruitment was performed by randomly matching each case of myomectomy performed using a tourniquet with two cases of myomectomy without tourniquet (50 cases vs 100 witnesses). We used as a tourniquet, the surgical glove knotted and tightened sufficiently at the level of the isthmus of the uterus to temporarily occlude the uterine arteries to ensure haemostasis lasting no more than one hour. Results: The mean age of the patients was similar in both groups (36, 1 ± 2.2 years vs 36.2 ± 1.9 years, P > 0.05). Menorrhagia was the most common indication of myomectomy in both groups (76% vs. 78% P > 0.05). The mean haemoglobin level of the patients before the myomectomies was 9.03 ± 1.10 g/dl vs 9, 75 ± 1.29 g/dl;P > 0.05. Intraoperative uterine features were similar in size (18 weeks gestation, 14 - 24) and number of myomas (5 vs 4, P > 0.05) in both groups. Polymyomectomy was more common in both groups (76% vs 73%, P > 0.05). Blood loss was reduced in the tourniquet group (90.5 ± 4.6 ml vs 200.4 ± 5.6 ml;P 0.05), as well as the use of blood transfusion (8% vs 50%, P 0.05). Use of the number of sutures was reduced in the group with tourniquet (3 ± 0.2 vs 6 ± 0.2 P 0.05). The duration of the procedure was shorter in the group with tourniquet (51.5 ± 4 min vs 83 ± 7 min, P 0.05). Postoperative mean haemoglobin of patients was no different between the two groups (9.4 ± 0.7 g/dl vs 9.2 ± 0.5, P > 0.05). The overall cost of management was reduced in the group with tourniquet (190,680 ± 1450 F CFA vs 256,800 ± 2350 FCFA;P 0.05). Conclusion: The use of tourniquet during myomectomies significantly reduces blood loss and the use of blood transfusion. We also obtain the notorious reduction in th

关键词： Tourniquet myoma Myomectomies Prevention Haemorrhage Cost Brazzaville Congo

Ulipristal Acetate (UPA): An Alternative Option to Surgery for Uterine Fibroids in Reproductive Age: A Review

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Yangtze Medicine 2022年第1期6卷 1-11页

作者： Subash Chandra Sharma Cunjian Yi Department of Gynecology and Obstetrics The First Affiliated Hospital of Yangtze University Jinzhou China

Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.

关键词： myoma Females Uterine Fibroids Selective Progesterone Receptor Modulator (SPRM) Ulipristal Acetate (UPA)

African Woman Sexuality: Assessment after Hysterectomy for Uterine Benign Disorders Based on Two Scales;PISQ 12/DFSI

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1445-1455页

作者： Koffi Abdoul E. Kacou Aka M. Fanny A. Cauphy N. Olou J. M. Konan A. Horo Department of Gynecology and Obstetrics University Felix Houphouet Boigny Abidjan Cote d’Ivoire

Background: Several authors are studying sexual activity of hysterectomies women. However, the review of literature reveals few data in sub-Saharan Africa on the psychological and sexual impact of this treatment option. Objective: To assess sexual activity and sexual satisfaction of women after hysterectomy for benign disorders. Methods: Single center analytical study based on patient opinion. It was conducted in a five-year period: from January 2012 to December 2016 at the Yopougon teaching Hospital. Results: Hysterectomy accounted for 15.9% of gynecological surgical activities. Hysterectomy for benign pathology accounted for 3.3% of hysterectomies. The average age was 47.6 years old. The indications were dominated by uterine fibroid (88.68%). Hysterectomy was performed by the abdominal route in 86.79% of cases. Sexual activity was resumed in the second trimester post-operative in 69.81%. After hysterectomy, dyspareunia was reduced (p 0.05), orgasm was more intense (p 0.05) with a greater sexual satisfaction (p 0.05). Conclusion: This study shows that there is no significant difference for women’s sexuality before and after hysterectomy.

关键词： Hysterectomy Sexuality myoma Africa