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Uterine Fibroid

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1. Ultrasound-guided high-intensity transcutaneous focused ultrasound for symptomatic uterine fibroids

Ultrasound-guided high-intensity transcutaneous focused ultrasound for symptomatic uterine fibroids Ultr Ultrasound-guided high-intensity tr asound-guided high-intensity transcutaneous anscutaneous focused ultr focused ultrasound for symptomatic uterine asound for symptomatic uterine fibroids fibroids Interventional procedures guidance Published: 24 July 2019 www.nice.org.uk/guidance/ipg657 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after (...) Recommendations Recommendations 1.1 Current evidence on the safety of ultrasound-guided high-intensity transcutaneous focused ultrasound for symptomatic uterine fibroids shows there are well-recognised complications including skin burns. The evidence on © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 5efficacy is limited in quality. Therefore, this procedure should only be used with special arrangements for clinical

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

2. Fibristal - ulipristal acetate - Uterine fibroids (signs and symptoms)

Fibristal - ulipristal acetate - Uterine fibroids (signs and symptoms) ulipristal acetate | CADTH.ca Find the information you need ulipristal acetate ulipristal acetate Last Updated: August 1, 2019 Result type: Reports Project Number: SF0609-000 Product Line: Generic Name: ulipristal acetate Brand Name: Fibristal Manufacturer: Allergan Inc. Indications: Uterine fibroids (signs and symptoms) Submission Type: Request For Advice Project Status: Complete Biosimilar: No Companion Diagnostics (...) : No Date Recommendation Issued: July 24, 2019 Recommendation Type: Reimburse with clinical criteria and/or conditions Key Milestones 1 Call for patient input posted March 29, 2019 Patient group input closed May 21, 2019 Clarification: - Patient input submission received from CANFib (Canadian Women with Fibroids Incorporated) and the Women’s Health Initiative Network Patient input summary sent for review to patient input groups May 14, 2019 Patient group comments on input summary closed May 21, 2019

2019 Canadian Agency for Drugs and Technologies in Health - Common Drug Review

3. Uterine fibroids

Uterine fibroids Uterine fibroids - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Uterine fibroids Last reviewed: February 2019 Last updated: September 2018 Summary Most common benign uterine tumour. Most are asymptomatic; however, can present with excessive uterine bleeding, symptoms secondary to pressure on bladder and rectum, and, less often, distortion of the uterine cavity, leading to miscarriage or infertility (...) , or symptomatic management with non-steroidal anti-inflammatory drugs (NSAIDs). Definition Uterine fibroids (leiomyomata) are benign tumours of the uterus primarily composed of smooth muscle and fibrous connective tissue. Breech LL, Rock JA. Leiomyomata uteri and myomectomy. In: Rock JA, Jones III HW, eds. Te Linde's operative gynecology, 9th edition. Philadelphia, PA: JB Lippincott Co.; 2003:753-98. They range in size from seedlings to large uterine tumours. Grossly, these tumours are round, firm, and well

2018 BMJ Best Practice

4. Uterine fibroids

Uterine fibroids Uterine fibroids - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Uterine fibroids Last reviewed: February 2019 Last updated: September 2018 Summary Most common benign uterine tumour. Most are asymptomatic; however, can present with excessive uterine bleeding, symptoms secondary to pressure on bladder and rectum, and, less often, distortion of the uterine cavity, leading to miscarriage or infertility (...) , or symptomatic management with non-steroidal anti-inflammatory drugs (NSAIDs). Definition Uterine fibroids (leiomyomata) are benign tumours of the uterus primarily composed of smooth muscle and fibrous connective tissue. Breech LL, Rock JA. Leiomyomata uteri and myomectomy. In: Rock JA, Jones III HW, eds. Te Linde's operative gynecology, 9th edition. Philadelphia, PA: JB Lippincott Co.; 2003:753-98. They range in size from seedlings to large uterine tumours. Grossly, these tumours are round, firm, and well

2018 BMJ Best Practice

5. Preoperative medical therapy before surgery for uterine fibroids. (PubMed)

Preoperative medical therapy before surgery for uterine fibroids. Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However (...) ), and four compared SPRMs with placebo. Most results provided low-quality evidence due to limitations in study design (poor reporting of randomisation procedures, lack of blinding), imprecision and inconsistency. GnRHa versus no treatment or placebo GnRHa treatments were associated with reductions in both uterine (MD -175 mL, 95% CI -219.0 to -131.7; 13 studies; 858 participants; I² = 67%; low-quality evidence) and fibroid volume (heterogeneous studies, MD 5.7 mL to 155.4 mL), and increased preoperative

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2017 Cochrane

6. Selective progesterone receptor modulators (SPRMs) for uterine fibroids. (PubMed)

Selective progesterone receptor modulators (SPRMs) for uterine fibroids. Uterine fibroids are smooth muscle tumours arising from the uterus. These tumours, although benign, are commonly associated with abnormal uterine bleeding, bulk symptoms and reproductive dysfunction. The importance of progesterone in fibroid pathogenesis supports selective progesterone receptor modulators (SPRMs) as effective treatment. Both biochemical and clinical evidence suggests that SPRMs may reduce fibroid growth (...) of 1215 study participants. We could not extract complete data from three studies. We included in the meta-analysis 11 studies involving 1021 study participants: 685 received SPRMs and 336 were given a control intervention (placebo or leuprolide). Investigators evaluated three SPRMs: mifepristone (five studies), ulipristal acetate (four studies) and asoprisnil (two studies). The primary outcome was change in fibroid-related symptoms (symptom severity, health-related quality of life, abnormal uterine

2017 Cochrane

7. Healthcare resource utilization and costs among women diagnosed with uterine fibroids compared to women without uterine fibroids. (PubMed)

Healthcare resource utilization and costs among women diagnosed with uterine fibroids compared to women without uterine fibroids. Objective: To perform a retrospective, matched-cohort, longitudinal evaluation of annual pre- and post-diagnosis costs incurred among women with uterine fibroids (UF) (cases) compared to controls without UF. Methods: Data were derived from the IBM Watson Health MarketScan Commercial Claims and Encounters and Medicaid Multi-State databases. Women aged 18-64 years

2019 Current medical research and opinion

8. FSRH CEU response to European Medicines Agency recommendations regarding use of ulipristal acetate for management of uterine fibroids

FSRH CEU response to European Medicines Agency recommendations regarding use of ulipristal acetate for management of uterine fibroids FSRH CEU response to European Medicines Agency recommendations regarding use of ulipristal acetate for management of uterine fibroids - Faculty of Sexual and Reproductive Healthcare FSRH CEU response to European Medicines Agency recommendations regarding use of ulipristal acetate for management of uterine fibroids FSRH CEU response to European Medicines Agency (...) recommendations regarding use of ulipristal acetate for management of uterine fibroids Share this article Published on: 12 February 2018 File size: 225kb PDF File type: Clinical Statements The European Medicines Agency (EMA) is currently reviewing the safety of use of Esmya® (ulipristal acetate) for management of uterine fibroids. This review follows reports of a very small number of cases worldwide of serious liver injury in women using Esmya. Until the review process is complete, temporary restrictions have

2018 Faculty of Sexual & Reproductive Healthcare

9. Factors associated with uterine fibroid in Ghanaian women undergoing pelvic scans with suspected uterine fibroid (PubMed)

Factors associated with uterine fibroid in Ghanaian women undergoing pelvic scans with suspected uterine fibroid Uterine fibroids are the most common benign tumours affecting premenopausal women and are often associated with considerable hospitalization and morbidity. Literature shows virtually no study concerning the quantification of the main factors associated with uterine fibroids in Ghanaian women. The purpose of this study was to assess the main factors associated with uterine fibroid (...) between selected demographic and gynaecological characteristics and uterine fibroid appearance. All tests were two-tailed and p-value of less than 0.05 was interpreted as significant.The range, mean and standard deviation (SD) of the patients' age were 14-54 years, 31.89 years and ± 7.92 respectively. Factors that associated significantly with uterine fibroid in Ghanaian women included obesity (X2 = 17.3, p-value = 0.001), participant's age range (X2 = 47.4, p-value = 0.001), parity (X2 = -10.169, p

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2016 Fertility research and practice

10. Laparoscopic electromechanical morcellation of uterine fibroids during myomectomy orhysterectomy

Laparoscopic electromechanical morcellation of uterine fibroids during myomectomy orhysterectomy Laparoscopic electromechanical morcellation of uterine fibroids during myomectomy orhysterectomy Laparoscopic electromechanical morcellation of uterine fibroids during myomectomy orhysterectomy HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc (...) . Laparoscopic electromechanical morcellation of uterine fibroids during myomectomy orhysterectomy. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Uterine fibroids, also known as myomas or leiomyomas, are benign tumors originating in the myometrium. Laparoscopic electromechanical morcellation of uterine fibroids involves the use of mechanically powered cutting devices to break up fibroid tissue for removal during minimally invasive myomectomy or hysterectomy. For standard laparoscopic

2017 Health Technology Assessment (HTA) Database.

11. [Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids]

[Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des Uterusmyoms: Potenzialbewertung; Auftrag E14-04 [Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des Uterusmyoms: Potenzialbewertung; Auftrag E14-04 [Magnetic resonance (...) imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des

2017 Health Technology Assessment (HTA) Database.

12. [Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids]

[Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des Uterusmyoms: Potenzialbewertung; Auftrag E14-05 [Magnetic resonance imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des Uterusmyoms: Potenzialbewertung; Auftrag E14-05 [Magnetic resonance (...) imaging-guided high-intensity focused ultrasound therapy for uterine fibroids] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Magnetresonanztomografiegesteuerte hochfokussierte Ultraschalltherapie zur Behandlung des

2017 Health Technology Assessment (HTA) Database.

13. [Ultrasound-guided high-intensity focused ultrasound for uterine fibroids - addendum to commission H16-02B]

[Ultrasound-guided high-intensity focused ultrasound for uterine fibroids - addendum to commission H16-02B] Sonografiegesteuerte hochfokussierte ultraschalltherapie beim leiomyom des uterus: addendum zum auftrag H16-02B; auftrag H17-01 [Ultrasound-guided high-intensity focused ultrasound for uterine fibroids – addendum to commission H16-02B] Sonografiegesteuerte hochfokussierte ultraschalltherapie beim leiomyom des uterus: addendum zum auftrag H16-02B; auftrag H17-01 [Ultrasound-guided high (...) -intensity focused ultrasound for uterine fibroids – addendum to commission H16-02B] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Sonografiegesteuerte hochfokussierte ultraschalltherapie beim leiomyom des uterus

2017 Health Technology Assessment (HTA) Database.

14. Ultrasound-guided high-intensity focused ultrasound for uterine fibroids: Assessment according to õ137h Social Code Book V

Ultrasound-guided high-intensity focused ultrasound for uterine fibroids: Assessment according to õ137h Social Code Book V Sonografiegesteuerte hochfokussierte Ultraschalltherapie beim Leiomyom des Uterus: Bewertungen gemäß § 137h SGB V; Auftrag H16-02B [Ultrasound-guided high-intensity focused ultrasound for uterine fibroids: Assessment according to §137h Social Code Book V] Sonografiegesteuerte hochfokussierte Ultraschalltherapie beim Leiomyom des Uterus: Bewertungen gemäß § 137h SGB V (...) ; Auftrag H16-02B [Ultrasound-guided high-intensity focused ultrasound for uterine fibroids: Assessment according to §137h Social Code Book V] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Sonografiegesteuerte

2017 Health Technology Assessment (HTA) Database.

15. Magnetic resonance-guided focused ultrasound therapy (ExAblate 2000 InSightec Ltd.) for ablation of uterine fibroids

Magnetic resonance-guided focused ultrasound therapy (ExAblate 2000 InSightec Ltd.) for ablation of uterine fibroids Magnetic resonance-guided focused ultrasound therapy (ExAblate 2000; InSightec Ltd.) for ablation of uterine fibroids Magnetic resonance-guided focused ultrasound therapy (ExAblate 2000; InSightec Ltd.) for ablation of uterine fibroids HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation HAYES, Inc.. Magnetic resonance-guided focused ultrasound therapy (ExAblate 2000; InSightec Ltd.) for ablation of uterine fibroids. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016 Authors' objectives Description of Technology: Magnetic resonance–guided focused ultrasound (MRgFUS) combines thermal effects (due to absorption of acoustic energy) with magnetic resonance imaging to treat symptomatic uterine fibroids. Thermal ablation

2017 Health Technology Assessment (HTA) Database.

16. Laparoscopic radiofrequency volumetric thermal ablation (Acessa System Halt Medical Inc.) for treatment of uterine fibroids

Laparoscopic radiofrequency volumetric thermal ablation (Acessa System Halt Medical Inc.) for treatment of uterine fibroids Laparoscopic radiofrequency volumetric thermal ablation (Acessa System; Halt Medical Inc.) for treatment of uterine fibroids Laparoscopic radiofrequency volumetric thermal ablation (Acessa System; Halt Medical Inc.) for treatment of uterine fibroids HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Laparoscopic radiofrequency volumetric thermal ablation (Acessa System; Halt Medical Inc.) for treatment of uterine fibroids. Lansdale: HAYES, Inc. Healthcare Technology Brief Publication. 2016 Authors' objectives Uterine fibroids (also called leiomyomata or myomas) are common benign tumors of the myometrium, the smooth muscle layer of the uterus. They can produce pain, pressure, frequent and heavy bleeding

2017 Health Technology Assessment (HTA) Database.

17. Hysteroscopic morcellation for treatment of uterine submucosal fibroids and endometrial polyps

Hysteroscopic morcellation for treatment of uterine submucosal fibroids and endometrial polyps Hysteroscopic morcellation for treatment of uterine submucosal fibroids and endometrial polyps Hysteroscopic morcellation for treatment of uterine submucosal fibroids and endometrial polyps HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc (...) . Hysteroscopic morcellation for treatment of uterine submucosal fibroids and endometrial polyps. Lansdale: HAYES, Inc. Healthcare Technology Brief Publication. 2016 Authors' objectives Uterine fibroids account for nearly 40% of the approximately 600,000 hysterectomies performed each year in the United States. Endometrial polyps are also a common cause of abnormal uterine bleeding; they are found in 10% to 40% of symptomatic women, and in up to 12% of asymptomatic women. Description of Technology

2017 Health Technology Assessment (HTA) Database.

18. Uterine artery embolization for symptomatic uterine fibroids. (PubMed)

Uterine artery embolization for symptomatic uterine fibroids. Uterine fibroids cause heavy prolonged bleeding, pain, pressure symptoms and subfertility. The traditional method of treatment has been surgery as medical therapies have not proven effective. Uterine artery embolization has been reported to be an effective and safe alternative to treat fibroids in women not desiring future fertility. There is a significant body of evidence that is based on case controlled studies and case reports (...) controlled trials to request unpublished data.Randomised controlled trials (RCTs) of UAE versus any medical or surgical therapy for symptomatic uterine fibroids. The primary outcomes of the review were patient satisfaction and live birth rate (among women seeking live birth).Two of the authors (AS and JKG) independently selected studies, assessed quality and extracted data. Evidence quality was assessed using GRADE methods.Seven RCTs with 793 women were included in this review. Three trials compared UAE

2014 Cochrane

19. A New Paradigm for Uterine Fibroid Treatment: Transcervical, Intrauterine Sonography-Guided Radiofrequency Ablation of Uterine Fibroids with the Sonata System (PubMed)

A New Paradigm for Uterine Fibroid Treatment: Transcervical, Intrauterine Sonography-Guided Radiofrequency Ablation of Uterine Fibroids with the Sonata System This article provides the current evidence related to transcervical radiofrequency ablation of uterine fibroids under integrated intrauterine sonography guidance (the Sonata System).Published data on the treatment of fibroids with the Sonata System has demonstrated significant median reductions in total (73.3%) and perfused (73.3 (...) %) uterine fibroid volume, menstrual bleeding (72.3%), symptom severity (62.5%), and improvements in health-related quality of life (127%) at 12 months post-ablation. A clinical trial under an FDA Investigational Device Exemption is in progress.The Sonata System is a promising treatment modality for uterine fibroids. As an incisionless, minimally invasive treatment that does not require general anesthesia or hospitalization, it has the potential for redefining the current paradigm for management

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2017 Current obstetrics and gynecology reports

20. Uterine fibroids: Correlations of anemia and pain to fibroid location and uterine weight. (PubMed)

Uterine fibroids: Correlations of anemia and pain to fibroid location and uterine weight. To estimate the prevalence of anemia, pelvic pain and heavy vaginal bleeding among symptomatic women with and without submucosal fibroids who presented for uterine fibroid embolization (UFE), and to determine if uterine weight was related to patient reports of heavy bleeding and pelvic pain.A case series study was performed that reviewed the ambulatory medical records of 357 symptomatic women with uterine (...) fibroids seeking UFE from 2001 to 2009. Women with at least one submucosal fibroid were included as cases. Uterine weight was calculated by using ultrasound measurements.Women, regardless of fibroid location, were equally likely to report heavy bleeding or be diagnosed with anemia. However, among women with complaints of pelvic pain or heavy bleeding, uterine weight was found to be higher in women with at least one submucosal fibroid as compared to women with fibroids in locations other than

2017 Journal of Reproductive Medicine

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