Myoma Uteri

myomauteri-1-0-25kapak

Leiomyoma and Recurrence

Hüseyin Aydoğmuş

Atatürk Research and Treatment Hospital, Department of Gynecology and Obstetric, İzmir, Türkiye

Aydoğmuş H. Leiomyoma and Recurrence. Yavuz AF, ed. Myoma Uteri. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.187-195.

ABSTRACT

Uterine leiomyomas are benign tumors characterized by uterine muscle cell proliferation and collagenous matrix production There are several medical, interventional radiological and surgical treatment options for uterine fibroids. Although hysterectomy is the radical treatment of uterine fibroids (UF), it is not suitable for patients who want to preserve their uterus or sexual pleasure. The recurrence risk is increased after conservative treatment procedures. considered that, risk factors for UF recurrence include the presence of more than three fibroids, women in the 4th and 5th decades, rapid tumor growth, and certain histological types of UF.

Preoperative use of GnRH analogs significantly reduce the fibroid volumes. However some studies have shown that treatment with GnRHa before myoma resection leads to an increased risk of recurrence. Ulipristal acetate another medical therapy option that effectively control abnormal uterine bleeding and downsize myomas in patients with symptomatic myomas. The most common radiological procedure is uterine artery embolization (UAE). It has been shown that patient satisfaction with the procedures and the rate of complications were similar for UAE and surgery at two and five years. High-intensity focused ultrasound (HIFU) is a technology that used to selectively ablate fibroids. In a study comparing surgery and HIFU it has been suggested that HIFU group had a lower symptom recurrence rate but a higher re-intervention rate. Uterine preserving surgical approach of fibroids is myomectomy which can be performed by open surgery, laparoscopy or hysteroscopy. Up to 30% recur- rence may occur after myomectomy. Recurrence of UFs lead to increased costs, hospital admissions, transfusions, and pain. Despite the presence promising investigations, further research is necessary to achieve the prevention of the recurrence of fibroids after conservative treatment.

Keywords: Leiomyoma; Uterine neoplasms; Uterine fibroid; Recurrence

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