Experience with Uterine Leiomyomas at a Teaching Referral Hospital in India.

Autor: Bhat, Rani Akhil, Dgo, Pratap Kumar N.
Předmět:
Zdroj: Journal of Gynecologic Surgery; Winter2006, Vol. 22 Issue 4, p143-150, 8p, 8 Charts
Abstrakt: Background: A leiomyoma is the commonest benign solid tumor of the reproductive tract and is a commonly encountered problem in gynecological practice. This study was carried out to observe the frequency of leiomyomas in relation to age, parity, and clinical manifestations, along with a review of its management. Methods: This study was carried out at the Department of Obstetrics and Gynecology, Kasturba Hospital (Manipal, India) from June 2003 to December 2004. All patients with symptomatic uterine leiomyomas were included in the study. Data collected included age, parity, menstrual pattern, presenting symptoms, diagnostic criteria, and outcome of various methods of management. Results: A total of 150 cases were observed during the study period. Greater frequency was found in the fourth (51%) and fifth (30%) decades of life. Ninety-five percent (95%) of the women were parous and 5% were nulliparous. The common mode of presentation was menstrual disturbances (80.5%), such as menorrhagia and dysmenorrhea. Leiomyomas were multiple in 65% and the commonest variety was intramural (52%). Diagnosis was based on clinical examination in 59.5% of the cases, and the remaining patients required ultrasonography to facilitate the diagnosis. Surgery was performed in 74.7%, of which 23.9% of patients underwent myomectomy and 76.2% hysterectomy. The remaining 25.3% of patients received medical therapy. Minimally invasive surgery was not possible in our setup. Conclusions: Leiomyoma is a common benign gynecological tumor encountered by gynecologists. Symptomatic myomas can cause significant morbidity. Leiomyomas commonly present with either menstrual disturbance, abdominal or pelvic pain, or reproductive disturbances. Diagnosis can be made accurately on clinical examination, but ultrasonography is the best diagnostic tool to confirm the clinical findings. (J GYNECOL SURG 22:143) [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index