Recurrence of Uterine Fibroids After Conservative Surgery or Radiological Procedures: a Narrative Review.
Tommaso CapezzuoliBatuhan AslanSilvia VannucciniGretha OrlandiFrancesco La TorreFlavia SorbiMassimiliano FambriniFelice PetragliaPublished in: Reproductive sciences (Thousand Oaks, Calif.) (2023)
The present narrative review aims to discuss the available data on the incidence and the risk factors of uterine fibroids (UFs) recurrence after different types of conservative surgical or radiologic procedures in women wishing to preserve their uterus. UFs are the most common benign tumors in women all over the world. Clinical presentation, including abnormal uterine bleeding (AUB), pelvic pain, bulky symptoms, and infertility affect patients' quality of life, and a large variety of conservative treatments are available especially for those with desire of pregnancy. Fertility sparing surgery, by either laparoscopy, hysteroscopy or laparotomy, or radiological interventions (uterine artery embolization, high-intensity focused ultrasound or magnetic resonance-guided focused ultrasound), are the most common therapeutic approaches. However, the genetic or acquired predisposition to UFs remain despite the treatments, and the recurrences are frequently described in a large percentage of patients. The most relevant risk factors for recurrence of UFs are young age at the first surgery, incomplete fibroid resection, the presence of multiple lesions, an enlarged uterus, and the coexistence with other pelvic diseases. The discussion on the possible medical strategy to reduce the recurrence is an open field of clinical investigation, in particular by using hormonal drugs.
Keyphrases
- minimally invasive
- risk factors
- high intensity
- magnetic resonance
- end stage renal disease
- polycystic ovary syndrome
- ejection fraction
- pregnancy outcomes
- chronic kidney disease
- coronary artery bypass
- healthcare
- prognostic factors
- chronic pain
- magnetic resonance imaging
- rectal cancer
- gene expression
- computed tomography
- peritoneal dialysis
- type diabetes
- preterm birth
- coronary artery disease
- resistance training
- robot assisted
- depressive symptoms
- neuropathic pain
- pregnant women
- insulin resistance
- copy number
- body composition
- middle aged
- contrast enhanced