Study Seeks Women’s Insights on What Works Best for Uterine Fibroids

Contact: Sarah Avery Phone: 919-660-1306 Email: sarah.avery@duke.edu https://www.dukehealth.org FOR IMMEDIATE RELEASE on Monday, May 9, 2016 DURHAM, N.C. – A new registry that launches this month gives women who have uterine fibroids the opportunity to help determine which strategies are most effective in treating the common condition. The registry, called Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF), will enroll more than 10,000 women at clinics affiliated with nine medical centers across the country. Participating women will be asked at annual intervals specific questions about the treatments they’ve elected to receive, and how well the treatments seem to be working for them. Approximately three years after initial treatment, researchers at the Duke Clinical Research Institute (DCRI) will analyze the patients’ feedback to determine which procedures provide the greatest benefit to women – insights that have been lacking for both women and their physicians.  Specifically, studies will focus on symptom relief, reproductive effects, and effectiveness among different patient subgroups, including African-American women, who are disproportionately affected by uterine fibroids. “This is a common condition – it affects up to 75 percent of women to varying degrees and is the leading cause of hysterectomies in the country – yet we don’t know which treatment works best for a given patie...
Source: DukeHealth.org: Duke Health Features - Category: Pediatrics Tags: Duke Medicine Source Type: news

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We report the case of a 28-year-old nulliparous female with unexplained infertility who underwent freeze-all vaginal oocyte retrieval. Twenty-one days later she presented with vaginal bleeding (similar to menstruation) and right lower-quadrant pain. The results of ultrasound scanning and a laboratory work-up were consistent with an ectopic pregnancy. She underwent laparoscopic right salpingectomy for a tubal ectopic pregnancy. We recommend sexual abstinence during assisted reproduction to lower the risk of multiple pregnancy and especially of heterotopic pregnancy.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Abstract Uterine leiomyomata are the most common benign tumors of the gynecologic tract impacting up to 80% of women by 50 years of age. It is well established that these tumors are the leading cause for hysterectomy with an estimated total financial burden greater than $30 billion per year in the United States. However, for the woman who desires future fertility or is a poor surgical candidate, definitive management with hysterectomy is not an optimal management plan. Typical gynecologic symptoms of leiomyoma include infertility, abnormal uterine bleeding (AUB)/heavy menstrual bleeding (HMB) and/or intermenstrual...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Abstract Myomas, also known as fibroids, are a specific characteristic of the human species. No other primates develop fibroids. At a cellular level, myomas are benign hyperplastic lesions of uterine smooth muscle cells. There are interesting theoretical concepts that link the development of myomas in humans with the highly specific process of childbirth from an upright position and the resulting need for greatly increased "expulsive" forces during labor. Myomas might be the price our species pays for our bipedal and highly intelligent existence. Myomas affect, with some variability, all ethnic groups an...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Leiomyoma can lead to significant morbidity in reproductive-aged women, causing symptoms that range from bleeding and pain to infertility. Despite recent progress made regarding tumor mitogens and nonsurgical treatments, the exact pathogenesis of fibroids remains unknown. Prolactin has been implicated as a mitogen growth factor in leiomyoma. Antipsychotic medications, in lowering dopamine levels and thereby removing the inhibition of prolactin secretion, can increase serum prolactin levels. Given this relationship, it stands to reason that antipsychotics may have a deleterious effect on myometrial smooth muscle cells.
Source: Psychosomatics - Category: Psychiatry & Psychology Authors: Source Type: research
Publication date: Available online 30 March 2018 Source:Case Reports in Women's Health Author(s): Ashima Arora, Shameema Anvar Sadath Genital tuberculosis is usually diagnosed in young women being assessed for infertility. After menopause it usually presents with symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent vaginal discharge and pyometra. The diagnosis is made by detection of acid-fast bacilli on microscopy or bacteriological culture and/or presence of epithelioid granuloma on biopsy. Anti-tubercular therapy involves the use of rifampicin, isoniazid, pyrazinamide and ethambutol. ...
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Like endometriosis, uterine adenomyosis is another enigmatic disease and remains a source of controversy. Uterine adenomyosis is characterized by the presence of endometrial glands in the myometrium. Two main theories may explain its pathogenesis: adenomyosis may arise from invagination of the myometrial basalis into the myometrium; or an alternative theory maintains that it may result from metaplasia of displaced embryonic pluripotent m üllerian remants or differentiation of adult stem cells. Uterine adenomyosis is responsible for pelvic pain, abnormal bleeding, and infertility.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Views and reviews Source Type: research
Women with symptomatic uterine fibroids can report a myriad of symptoms, including pain, bleeding, infertility, and psychosocial sequelae. Optimizing fibroid research requires the ability to enroll populations of women with image-confirmed symptomatic uterine fibroids.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Original Research Source Type: research
Conclusion According to the most recent literature, hysteroscopic hystmoplasty appears to be a safe and effective treatment option in cases of isthmocele with a niche at least 2 mm deep and a residual myometrial thickness of at least 3 mm to improve postmenstrual bleeding. When residual myometrial thickness is <3 mm, the hysteroscopic approach is not recommended, mainly because of the risk of bladder injury. In these symptomatic cases, laparoscopic or vaginal repair may be considered.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion Even though the literature is cloudy in this area, a laparoscopic approach to repairing an isthmocele is a safe and minimally invasive procedure. Our approach described here involves inserting a Foley catheter in the uterine cavity through the cervical canal, then filling the balloon in the lower uterine segment under laparoscopic view to identify the isthmocele.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: January 2018 Source:Journal of Minimally Invasive Gynecology, Volume 25, Issue 1 Author(s): Antonio Setubal, João Alves, Filipa Osório, Adalgisa Guerra, Rodrigo Fernandes, Jaime Albornoz, Zacharoula Sidiroupoulou An isthmocele appears as a fluid pouchlike defect in the anterior uterine wall at the site of a prior cesarean section and ranges in prevalence from 19% to 84%, a direct relation to the increase in cesarean sections performed worldwide. Many definitions have been suggested for the dehiscence resulting from cesarean sections, and we propose standardization with a single term for all...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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