Uterine Fibroids

Women with submucosal uterine leiomyomas who undergo hysteroscopic removal have comparable birth outcomes to women with submucosal uterine leiomyomas who do not have hysteroscopic removal, according to a retrospective case-control study in the American Journal of Obstetrics & Gynecology MFM.

High signal intensity on T1-weighted magnetic resonance images (MRI) and low diffusion coefficient values can accurately differentiate uterine leiomyosarcoma from benign leiomyoma, according to a meta-analysis in the Journal of the Belgium Society of Radiology.

A small clinical trial has found that transvaginal high-intensity focused ultrasound (vHIFU) is a promising treatment for women with symptomatic uterine leiomyomas.

Because obstructive uropathy due to gynecologic benignities is an extremely rare, difficult, and challenging life-threatening condition, physicians should always consider the existence of uropathy.

“There is a large unmet need in the uterine fibroid space for noninvasive treatment options,” said Ayman Al-Hendy, MD, Ph.D., lead author of the analysis and a professor of ob/gyn at The University of Chicago.

Study results, which were published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, also found the drug well tolerated.

A prospective observational study in the Journal of Ultrasound in Medicine has concluded that for pretreatment evaluation of uterine fibroids (UF), transabdominal contrast-enhanced ultrasound (CEUS) represents a viable alternative to traditional contrast-enhanced magnetic resonance imaging (MRI).

Although myomectomy may prolong the operative time and the postoperative hospital stay, there are numerous potential benefits including avoiding a follow-up operation to remove uterine fibroids.

High-intensity focused ultrasound (HIFU) for the treatment of uterine fibroids may not significantly increase the risk of pelvic adhesions.

In this video, a clinician discusses new data on how surgeons are doing tissue extraction for uterine fibroids.

An updated review of evidence by the US Food and Drug Administration (FDA) underscores concerns expressed in 2014 by the agency about use of laparoscopic power morcellators (LPM) for treatment of uterine fibroids. Plus: Prescription habits show ob/gyns not well informed about opioids, according to a study. Also: Does ADHD medication use during pregnancy increase risk of congenital malformations?

A study tabulates the direct and indirect costs.

For women in whom surgery is not recommended or necessary, treatment with the goal of symptom relief and size reduction can be achieved medically.

Questions and answers from SMFM about the implications of uterine fibroids during pregnancy

Two studies show that the emotional impact of uterine fibroids is significant but support is lacking, especially in African American women.

William Fredette, MD, discusses the benefits of Antiprogestin CDB-2914 for reducing uterine fibroid size and bleeding, and improving quality of life for affected women, as reported in the journal Fertility and Sterility. Video provided by The Doctor's Channel.

Institutions around the country have responded to an FDA advisory by discouraging or banning power morcellation of uterine fibroids. Innovative methods of contained morcellation are now called for.

Gynecologic surgeons should give consideration to the balance of benefit and harm that accompanies laparoscopic tissue morcellation, in addition to exploring surgical alternatives and methods to mitigate complications.