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. 2017 Jul-Sep;21(3):e2017.00041.
doi: 10.4293/JSLS.2017.00041.

Symptomatic Fibroid Management: Systematic Review of the Literature

Yelena Havryliuk  1 , Robert Setton  1 , John J Carlow  2 , Barry D Shaktman  1
Affiliations

Symptomatic Fibroid Management: Systematic Review of the Literature

Yelena Havryliuk et al. JSLS. 2017 Jul-Sep.

Abstract

Background and objectives: Symptomatic uterine fibroids are a societal and healthcare burden with no clear consensus among medical professionals as to which procedural treatment is most appropriate for each symptomatic patient. Our purpose was to determine whether recommendations can be made regarding best practice based on review and analysis of the literature since 2006.

Database: A systematic search of journal articles relevant to the treatment of symptomatic uterine fibroids was performed within PubMed, clinical society websites, and medical device manufacturers' websites. All clinical trials published in English, representing original research, and reporting clinical outcomes associated with interventions for the management of symptomatic uterine fibroids were considered. Each article was screened and selected based on study type, content, relevance, American College of Obstetricians and Gynecologists score, and internal/external validity. Outcomes of interest were patient baseline characteristics, fibroid characteristics, procedural details, complications, and long-term follow-up. Random-effects meta-analyses were used to test the quantitative data. Assessment of 143 full-length articles through January 2016 produced 45 articles for the quantitative analysis. The weighted combined results from hysterectomy trials were compared with those from uterine-preserving fibroid studies (myomectomy, uterine artery embolization, laparoscopic radiofrequency ablation, and magnetic resonance-guided focused ultrasound).

Conclusion: We explored trends that might guide clinicians when counseling patients who need treatment of symptomatic fibroids. We found that fibroid therapy is trending toward uterine-conserving treatments and outcomes are comparable across those treatments. Since minimally invasive options are increasing, it is important for the clinician to provide the patient with evidence-based therapeutic strategies.

Keywords: Intervention; Leiomyoma; Symptomatic fibroid; Uterine.

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References

    1. Baird DD, Dunson DB, Hill MV, Cousins D, Schechtman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–107. - PubMed
    1. Borah BJ, Nicholson WK, Bradley L, Stewart EA. The impact of uterine leiomyomas: a national survey of affected women. Am J Obstet Gynecol. 2013;209:319.e1–319.e20. - PMC - PubMed
    1. Pritts EA, Parker WH, Olive DL. Fibroids and Infertility: an updated systematic review of the literature. Fertil Steril. 2009;91:1215–1223. - PubMed
    1. Lee HJ, Norwitz ER, Shaw J. Contemporary management of fibroids in pregnancy. Rev Obstet Gynecol. 2010;3:20–27. - PMC - PubMed
    1. Cardozo ER, Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH. The estimated annual cost of uterine leiomyomata in the United States. Am J Obstet Gynecol. 2012;206:211.e1–211.e9. - PMC - PubMed

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