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Uterine Fibroid

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

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

2017 Current obstetrics and gynecology reports PubMed abstract

62. Factors associated with uterine fibroid in Ghanaian women undergoing pelvic scans with suspected uterine fibroid (Full text)

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

2016 Fertility research and practice PubMed abstract

63. Magnetic resonance guided focused ultrasound surgery (MRgFUS) for uterine fibroids

Magnetic resonance guided focused ultrasound surgery (MRgFUS) for uterine fibroids File Name: 20151202 AS MRgFUS fibroids v1.0.docx Version: 1.0 Date: 22 January 2016 Produced by: SHTG Page: 1 Review date: December 2017 Advice Statement 001/2015 December 2015 Is magnetic resonance guided focused ultrasound surgery (MRgFUS) for the treatment of uterine fibroids clinically effective, safe and cost effective compared with uterine artery embolisation (UAE), myomectomy and hysterectomy? This advice (...) has been produced following completion of evidence note 55 by Healthcare Improvement Scotland, in response to an enquiry from NHS National Services Scotland Background MRgFUS is a non-invasive treatment for symptomatic uterine fibroids typically performed on an outpatient basis by an interventional radiologist. Currently there are two CE marked MRgFUS systems, namely Insightec’s ExAblate 2000 system and upgraded ExAblate 2100 conformational system (Insightec) and Philips’ Sonalleve (Philips

2015 SHTG Advice Statements

64. Aromatase inhibitors for uterine fibroids. (Abstract)

Aromatase inhibitors for uterine fibroids. Uterine fibroids, also called uterine leiomyomas or myomas, are the most common benign tumours in women of reproductive age. Albeit generally benign, uterine fi broids can have a major impact on women's health and quality of life by contributing to abnormal uterine bleeding and causing pelvic pressure symptoms (such as increased urinary frequency, pelvic pain and constipation). Traditional treatments for symptomatic fi broids include a variety (...) trial did not report data on fibroid volume in a form that permitted calcuation of an odds ratio. Morevoer it was unblinded and included only 60/70 women in analysis.Evidence is insufficient to support the use of AI drugs in the treatment of women with uterine fibroids.

2013 Cochrane

65. A comparative study on the effects of MRI- and CT-guided interventional therapies on uterine fibroids. (Full text)

A comparative study on the effects of MRI- and CT-guided interventional therapies on uterine fibroids. To compare the effects of MRI- and CT-guided interventional therapies on uterine fibroids.A total of 280 patients with uterine fibroids who were treated in our hospital from August 2008 to February 2014 were selected and divided into a treatment group and a control group by random draw (n=140). The control group and the treatment group were subjected to CT- and MRI-guided interventional (...) therapies for uterine artery embolization.After three months of treatment, 94.3% and 92.9% of heavy menstrual bleeding and pelvic pressure of the treatment group were relieved respectively, which were similar to those of the control group (92.9% and 92.1% respectively) (P>0.05). The two groups had similar uterine and fibroid sizes before treatment, which were all significantly decreased after treatment (P<0.05) when the treatment group had significantly smaller uteri and fibroids than the control group

2019 Pakistan Journal Of Medical Sciences Controlled trial quality: uncertain PubMed abstract

66. Safety and efficacy of the selective progesterone receptor modulator asoprisnil for heavy menstrual bleeding with uterine fibroids: pooled analysis of two 12-month, placebo-controlled, randomized trials. (Full text)

Safety and efficacy of the selective progesterone receptor modulator asoprisnil for heavy menstrual bleeding with uterine fibroids: pooled analysis of two 12-month, placebo-controlled, randomized trials. Can asoprisnil, a selective progesterone receptor modulator, provide clinically meaningful improvements in heavy menstrual bleeding (HMB) associated with uterine fibroids with an acceptable safety profile?Uninterrupted treatment with asoprisnil for 12 months effectively controlled HMB (...) and reduced fibroid and uterine volume with few adverse events.In a 3-month study, asoprisnil (5, 10 and 25 mg) suppressed uterine bleeding, reduced fibroid and uterine volume, and improved hematological parameters in a dose-dependent manner.In two Phase 3, double-blind, randomized, placebo-controlled, multicentre studies, women received oral asoprisnil 10 mg, asoprisnil 25 mg or placebo (2:2:1) once daily for up to 12 months.Premenopausal women ≥18 years of age in North America with HMB associated

2019 Human Reproduction Controlled trial quality: predicted high PubMed abstract

67. Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids. (Full text)

Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids. The aim of the present study was to investigate factors affecting ablation effect and safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids (UFs).A retrospective analysis of 346 patients with symptomatic UFs who were treated with USgHIFU was performed. All UFs was grouped based on magnetic resonance imaging (MRI) characteristics before HIFU; all adverse events (...) , hypointense (T2WI), and mild enhancement (T1WI contrast enhancement) UFs had the highest ablation rate. The EEF of the anterior, intramural, hypointense (T2WI), mild enhancement (T1WI contrast enhancement), and >5 cm UFs had minimum value, with a statistically significant difference (P < .01). According to multiple linear regression model, the distance from the UFs ventral side to the skin, enhancement type on T1WI, size of UFs, signal intensity on T2WI, location of UFs, type and volume of fibroids all

2019 Medicine PubMed abstract

68. Myometrial progesterone hyper-responsiveness associated with increased risk of human uterine fibroids. (Full text)

Myometrial progesterone hyper-responsiveness associated with increased risk of human uterine fibroids. Uterine Fibroids (UFs) growth is ovarian steroid-dependent. Previous studies have shown that estrogen and progesterone play an important role in UF development. However, the mechanism underlying progesterone induced UF pathogenesis is largely unknown. In this study, we determined the expression of progesterone receptor and compared the expression level of progesterone-regulated genes (PRGs

2019 BMC Women's Health PubMed abstract

69. Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report. (Full text)

Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report. Objective: This study evaluated the effect of oxytocin administration prior to microwave ablation (MWA) of hypervascular uterine fibroids. Methods: Thirty-two patients with 38 hypervascular uterine fibroids (Adler blood flow grade 3) were equally apportioned to receive intravenous oxytocin infusion (0.32 U/min) 20 min before ultrasound-guided (...) was noted. Conclusion: Intravenous oxytocin administered before percutaneous MWA of hypervascular uterine fibroids can effectively block the blood supply vessels of the myoma, reduce the heat sink effect, and thereby increase the ablation volume and improve the local therapeutic effect.

2019 International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group Controlled trial quality: uncertain PubMed abstract

70. Implementation of the uterine fibroids Option Grid patient decision aids across five organizational settings: a randomized stepped-wedge study protocol. (Full text)

Implementation of the uterine fibroids Option Grid patient decision aids across five organizational settings: a randomized stepped-wedge study protocol. Uterine fibroids are non-cancerous overgrowths of the smooth muscle in the uterus. As they grow, some cause problems such as heavy menstrual bleeding, pelvic pain, discomfort during sexual intercourse, and rarely pregnancy complications or difficulty becoming pregnant. Multiple treatment options are available. The lack of comparative evidence (...) demonstrating superiority of any one treatment means that choosing the best option is sensitive to individual preferences. Women with fibroids wish to consider treatment trade-offs. Tools known as patient decision aids (PDAs) are effective in increasing patient engagement in the decision-making process. However, the implementation of PDAs in routine care remains challenging. Our aim is to use a multi-component implementation strategy to implement the uterine fibroids Option Grid™ PDAs at five organizational

2019 Implementation Science Controlled trial quality: uncertain PubMed abstract

71. Randomised trial of two embolic agents for uterine artery embolisation for fibroids: Gelfoam versus Embospheres (RAGE trial). (Full text)

Randomised trial of two embolic agents for uterine artery embolisation for fibroids: Gelfoam versus Embospheres (RAGE trial). Uterine artery embolisation (UAE) is an established treatment option for women with symptomatic uterine fibroids who wish to avoid surgery. However the most efficacious embolic agent remains uncertain.We conducted a pilot double blind randomized controlled trial comparing Gelfoam with Embospheres in women undergoing UAE. Outcomes recorded at baseline, 24-h, 1 and 6 (...)  ± 26 in the E and G groups respectively. UFS-Qol HRQL also improved in both groups at 6 months, mean 41 ± 28 to 79 ± 20 and 53 ± 19 to 78 ± 21 in the E and G groups respectively.Uterine volume at 6 months reduced from 1018 ± 666mls to 622 ± 436 (p = 0.001) and from 1026 ± 756 to 908 ± 720 (p = 0.15) in the E and G groups respectively. There was a significant difference between groups for this parameter p = 0.01. All uterine arteries were patent at 24-h and 6 months. Complete (100%) fibroid

2019 CVIR endovascular Controlled trial quality: predicted high PubMed abstract

72. Diagnostic ambiguity of aseptic necrobiosis of a uterine fibroid in a term pregnancy: a case report. (Full text)

Diagnostic ambiguity of aseptic necrobiosis of a uterine fibroid in a term pregnancy: a case report. Uterine fibroids are the most common uterine tumours in females of reproductive age. During pregnancy, uterine fibroids may be complicated by aseptic necrobiosis. We herein report an ambiguous clinical presentation of uterine fibroids in pregnancy and discuss the diagnostic challenges encountered in our resource-constraint setting.A term pregnant Cameroonian woman was admitted to our maternity (...) unit with clinical findings suggestive of a strangulated umbilical hernia. She underwent an emergency caesarean section which fortuitously revealed aseptic necrobiosis of a uterine fibroid, managed within the same surgical intervention by myomectomy. Her post-operative course was uneventful.The authors highlight the need for a high index of suspicion by healthcare providers, as well as the need for a multidisciplinary approach for a favourable maternal and foetal outcome.

2019 BMC Pregnancy and Childbirth PubMed abstract

73. Lower prevalence of non-cavity-distorting uterine fibroids in patients with polycystic ovary syndrome than in those with unexplained infertility. (Abstract)

Lower prevalence of non-cavity-distorting uterine fibroids in patients with polycystic ovary syndrome than in those with unexplained infertility. To study whether there is a difference in the prevalence of non-cavity-distorting uterine fibroids between infertile patients with polycystic ovary syndrome (PCOS) and those with unexplained infertility (UI).A secondary analysis of data from three randomized clinical trials.Academic health centers.A total of 2,249 patients with normal uterine (...) -distorting uterine fibroids was lower in women with PCOS than in those with UI (6.7% vs. 12.4%); this result held after patients were divided into Black and non-Black or into three different body mass index groups. After adjustment for all the other variables in the final model, patients with PCOS had a significantly lower prevalence of fibroids than those with UI (odds ratio 0.54). No differences in the prevalence of non-cavity-distorting fibroids with any dimensions ≥4 cm or the volume of the largest

2019 Fertility and Sterility Controlled trial quality: uncertain

74. Acupuncture for uterine fibroids: Protocol for a systematic review of randomized controlled trials. (Full text)

Acupuncture for uterine fibroids: Protocol for a systematic review of randomized controlled trials. Uterine fibroids represent the most common gynecological benign tumors in reproductive females. Acupuncture has been applied as a therapeutic modality in China to treat uterine fibroids. However, currently, few critical systematic reviews regarding the effect of acupuncture on uterine fibroids have been published. Our proposed review aims to evaluate the current evidence on the efficacy (...) of acupuncture for uterine fibroids.A total of 7 databases were searched from their inception to December 2018, including PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials, the Chinese National Knowledge Infrastructure database, the Chinese Biomedical database, and the Wanfang database. The primary outcomes will be reduction in uterine volume and number of fibroids. Secondary outcomes are pelvic or low-back pain, assessed by Visual Analog Scale (VAS); Irregular menstrual periods

2019 Medicine PubMed abstract

75. Quality of Life, Adverse Events, and Reintervention Outcomes after Laparoscopic Radiofrequency Ablation for Symptomatic Uterine Fibroids: A Meta-Analysis. (Abstract)

Quality of Life, Adverse Events, and Reintervention Outcomes after Laparoscopic Radiofrequency Ablation for Symptomatic Uterine Fibroids: A Meta-Analysis. In this review, we assessed the short-term (3 and 6 months) and long-term (12, 24, and 36 months) symptom relief and quality of life improvement, procedure-related adverse event rate, reintervention rate, and days missed from work after laparoscopic radiofrequency ablation. Using MeSH keywords "uterine fibroid" and "ablation technique (...) ," a systematic search was performed in PubMed, Ovid, Embase, Cochrane Library, and Clinicaltrials.gov. Studies consisting of uterine fibroid symptoms and quality of life scores were considered eligible. Both comparative and noncomparative studies were included. Using a random-effects model, a meta-analysis was performed. Eight studies with a total of 581 patients were finally included in our review. Based on validated questionnaires, quality of life improved significantly until 36 months after laparoscopic

2019 Journal of minimally invasive gynecology

76. A systematic review and meta-analysis of ulipristal acetate for symptomatic uterine fibroids. (Abstract)

A systematic review and meta-analysis of ulipristal acetate for symptomatic uterine fibroids. Uterine fibroids cause menorrhagia and adversely affect quality of life. Ulipristal acetate (UPA) can improve fibroid symptoms.To assess the effectiveness of UPA in women with symptomatic uterine fibroids.We searched CENTRAL, MEDLINE, Embase, and CINHAL on December 31, 2018, using relevant search terms. Clinical trials registries were searched for ongoing trials and there were no language (...) with placebo. UPA significantly achieved amenorrhea (RR 24.54; 95% CI, 10.82-55.64), reduced blood loss, and improved quality of life with insufficient evidence from RCTs for adverse events. There was insufficient evidence for improved outcomes when UPA was compared with leuprolide acetate.Compared with placebo, oral UPA significantly induces amenorrhea, reduces heavy menses, and improves quality-of-life in women with uterine fibroids.© 2019 International Federation of Gynecology and Obstetrics.

2019 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

77. Prescription of Chinese herbal products is associated with a decreased risk of uterine fibroids: A population-based cohort study. (Full text)

Prescription of Chinese herbal products is associated with a decreased risk of uterine fibroids: A population-based cohort study. The finding of a decrease in subsequent fibroid-related operation following the use of Chinese herbal products (CHPs) has led to speculation that CHPs might play a role in uterine fibroids prevention.This study provides an overview of uterine fibroids incidence, comparing CHP users with those who do not use CHPs, referred to as non-CHP users. The results can provide (...) information to clinicians for counseling women about the preventive use of CHPs.A total of 52,151 women (20-45 years of age) were recruited from a nationwide 1-million-person representative sample of those covered by National Health Insurance in Taiwan and were followed from 2000 to 2013. Exact matching was performed for comparative analysis. The age-specific hazard ratios (HRs) of uterine fibroids in relation to either CHP or the phytoestrogen use were calculated with multivariate Cox proportional hazard

2019 Medicine PubMed abstract

78. Pregnancy Outcomes Following Ulipristal Acetate for Uterine Fibroids: A Systematic Review. (Abstract)

Pregnancy Outcomes Following Ulipristal Acetate for Uterine Fibroids: A Systematic Review. To determine pregnancy and fetal outcomes following treatment with ulipristal acetate (UPA) for symptomatic uterine fibroids.We conducted a systematic review and case series. We searched MEDLINE, EMBASE, PubMed, Web of Science, and Cochrane Register from inception to February 2017. From January 2014 to July 2017, we carried out a multi-centre retrospective chart review. All human studies that reported (...) is the first systematic review and largest reported case series evaluating pregnancy outcomes following UPA treatment for uterine fibroids. UPA alone, or in conjunction with surgery, can permit conception and favorable pregnancy outcomes.Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

2019 Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

79. Ulipristal acetate - Uterine fibroids

Ulipristal acetate - Uterine fibroids Common Drug Review CDEC Meeting — October 16, 2013 Notice of CDEC Final Recommendation — November 15, 2013 Page 1 of 5 © 2013 CADTH CDEC FINAL RECOMMENDATION ULIPRISTAL ACETATE (Fibristal — Actavis Specialty Pharmaceuticals) Indication: Uterine Fibroids Recommendation: The Canadian Drug Expert Committee (CDEC) recommends that ulipristal acetate be listed for the treatment of moderate to severe signs and symptoms of uterine fibroids in adult women (...) was shown to be superior to placebo (PEARL I) and non-inferior to leuprolide acetate (PEARL II) for decreasing menstrual bleeding in patients with uterine fibroids. In addition, ulipristal acetate was associated with fewer adverse events than leuprolide acetate in PEARL II. 2. At the submitted price, ulipristal acetate ($1,031 per three-month course) is less costly than leuprolide acetate ($1,042 per three-month course). Of Note: There were no data available in the included RCTs for patients

2013 Canadian Agency for Drugs and Technologies in Health - Common Drug Review

80. Uterine Artery Embolisation in the Management of Fibroids

Uterine Artery Embolisation in the Management of Fibroids Clinical recommendations on the use of uterine artery embolisation (UAE) in the management of fibroids Third edition (2013)2 Contents 1 Summary of recommendations 3 2 Introduction and background 4 3 Literature review 5 4 Indications for fibroid embolisation 8 5 Contraindications 9 6 Subfertile patients and those contemplating a subsequent pregnancy 10 7 Counselling, consent and communication 11 8 Pretreatment assessment and prophylactic (...) surgery. The technique was subsequently used for the management of arteriovenous malformations of the genital tract and in gestational trophoblastic disease. Ravina et al first used arterial embolisation to treat fibroids in 1991, publishing their series in 1995. 1 In 2000, a Joint Working Party of the Royal College of Obstetricians and Gynaecologists and The Royal College of Radiologists was established to issue guidance on uterine artery embolisation (UAE) – a procedure which at that time was in its

2013 Royal College of Obstetricians and Gynaecologists

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