Uterine Leiomyomatosis: A Case Study and Literature Review

Abstract

<h3>Study Objective</h3> The objective of this study is to examine techniques for management of diffuse uterine leiomyomatosis that preserve the patient's uterus and/or fertility. <h3>Design</h3> A literature search was performed and revealed seven papers, largely case series and case reports. <h3>Setting</h3> Academic medical center. <h3>Patients or Participants</h3> A 38-year-old G2P0020 with known history of fibroids and multiple transfusions, now presenting with worsening abnormal uterine bleeding unresponsive to oral progestin. <h3>Interventions</h3> Operative hysteroscopy, myomectomy, and dilation and curettage. Samples of several fibroids were taken along with an endometrial sample. <h3>Measurements and Main Results</h3> The patient was found to have diffuse uterine leiomyomatosis discovered via hysteroscopy. Literature search revealed a few different conservative methodologies for treatment of DUL, including medical management with GnRH agonists, partial myomectomy with and without GnRH agonist adjunct therapy, and uterine artery embolism. <h3>Conclusion</h3> While hysterectomy is the only definitive treatment for DUL, there exist many options for DUL treatment for the patient who wishes to preserve her uterus and/or her fertility.