Uterine Fibroids: Diagnosis and Treatment

Area of Science:

• Gynecology
• Oncology
• Radiology

Background:

• Uterine fibroids are common benign neoplasms with higher prevalence in older women and those of African descent.
• Many fibroids are asymptomatic and discovered incidentally.
• Symptomatic fibroids can cause significant pelvic discomfort and abnormal uterine bleeding.

Purpose of the Study:

• To review the diagnosis, management, and treatment options for uterine fibroids.
• To provide an overview of current medical and surgical interventions.
• To emphasize individualized treatment approaches based on patient characteristics.

Main Methods:

• Review of current literature on uterine fibroids.
• Discussion of diagnostic modalities, primarily ultrasonography.
• Analysis of medical and surgical treatment strategies.

Main Results:

• Ultrasonography is the preferred initial imaging modality for uterine fibroids.
• Expectant management is suitable for asymptomatic patients, with fibroids often shrinking during menopause.
• Medical therapies include hormonal contraceptives, tranexamic acid, NSAIDs, GnRH agonists, and SPRMs.
• Surgical options encompass hysterectomy, myomectomy, UAE, and MRgFUS.

Conclusions:

• Management of uterine fibroids requires a personalized approach considering fibroid characteristics, patient symptoms, age, fertility desires, and physician expertise.
• Treatment ranges from conservative management to hormonal therapies and surgical interventions.
• The choice of treatment aims to alleviate symptoms, manage bleeding, and address patient-specific needs.