Experience with trans radial uterine artery embolisation for uterine fibroids in a tertiary center in Saudi Arabia
Published on: 1st December, 2020
OCLC Number/Unique Identifier: 8812313094
Trans-radial uterine artery embolization (UAE) is acknowledged as a non- invasive, cost-effective and safe procedure for the treatment of symptomatic fibroids. However, it is associated with the recurrence of symptoms like abnormal uterine bleeding and pressure symptom in some patients. This is a comparative study of our data with other international data, in the context of percentage reduction in fibroid size, accompanying controlling factors, short and long term follow up data analysis of the first two years was done. Careful pre-procedural counseling of future possibility of fibroid recurrence and means of management should be stressed.
Materials and methods: A retrospective cohort study at the Security Forces Hospital in Riyadh, Saudi Arabia, was conducted. The study was done from 1st November 2017-31st October 2019, on symptomatic patients diagnosed with fibroids, who refused surgical treatment.
The outcomes included: fibroid site, size and anatomical position, patients’ symptoms, general condition, and early and delayed complications. These data were compared with those from other international studies.
Results: The study involved 23 patients (mean age: 39 years). The average percentage reduction in fibroid volume was 49%. There were no major complications and no recurrence of symptoms during the covered period. Data analysis revealed a poor correlation between the overall percentage reduction of fibroid size with fibroid number, age of patients’, and body mass indices.
Conclusion: Despite poor correlation, we provided preliminary data of the first two years out of the total five-year projected period of the study where it showed effectiveness and relative safety of radial - UAE for fibroid.
Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report
Published on: 20th June, 2023
Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification.Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy.Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139).Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.
Surgical and Delivery Outcomes of Coexisting Uterine Fibroids with Pregnancies in Nigeria
Published on: 19th March, 2024
Background: Coexisting uterine fibroid with pregnancy is associated with increased pregnancy complications. This study evaluates the prevalence of coexisting uterine fibroids, and surgical and delivery outcomes among pregnant women who had cesarean sections.Methods: This comparative observational study was conducted among pregnant women who had cesarean sections at the labor ward operating room of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. One hundred and five pregnant women aged 20 years - 40 years were recruited and grouped based on the intraoperative presence of grossly visible uterine fibroids (n = 23) and no uterine fibroids (n = 82). Surgical and delivery outcomes were measured. Data were analyzed using IBM SPSS version 26 and the means between the two groups were compared using an independent sample t-test with significance set at p < .05.Results: The prevalence of uterine fibroids found during cesarean sections in this study was 21.9%. The mean age of the participants was comparable (M = 30.25 SD = 5.232). There were statistically significant differences in mean pre-operative packed cell volume (t(df) = 2.077 (65.31) p = .042, estimated blood loss (t(df) = 2.045 (36.664) p =.010, post-op packed cell volume (t(df) = 1.054 (24.035) p = .049, and duration of hospital stay (t(df) = -.235(65.846) p = .019. The study showed that there was a difference in mean surgery time = 7.996 95% CI: -.879 to 16.871 but this was not found to be statistically significant. Conclusion: Uterine fibroid coexisting with pregnancy has a significant effect on the surgery time, estimated blood loss, and length of hospital stay. Therefore, adequate complication readiness and proper follow-up of the patient will be crucial to avert likely complications during and after surgery in women with coexisting uterine fibroid in pregnancy.
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