Uterine Fibroids Research Articles

Causal relationship between gut microbiota and gynecological tumor: a two-sample Mendelian randomization study.

Previous research has established associations between alterations in gut microbiota composition and various gynecologic tumors. However, establishing a causal relationship between gut microbiota and these tumors remains necessary. This study employs a two-sample Mendelian randomization (MR) approach to investigate causality, aiming to identify pathogenic bacterial communities potentially involved in gynecologic tumor development. Data from the MiBioGen consortium's Genome-Wide Association Study (GWAS) on gut microbiota were used as the exposure variable. Four common gynecologic neoplasms, including uterine fibroids (UF), endometrial cancer (EC), ovarian cancer (OC), and cervical cancer (CC), were selected as outcome variables. Single-nucleotide polymorphisms (SNPs) significantly associated with gut microbiota were chosen as instrumental variables (IVs). The inverse variance-weighted (IVW) method was used as the primary MR analysis to assess the causal relationship. External validation An was conducted using an independent. Sensitivity analyses were performed to ensure robustness. Reverse MR analysis was also conducted to assess potential reverse causation. Combining discovery and validation cohorts, we found that higher relative abundance of Lachnospiraceae is associated with lower UF risk (OR: 0.882, 95% CI: 0.793-0.982, P = 0.022). Conversely, higher OC incidence is associated with increased relative abundance of Lachnospiraceae (OR: 1.329, 95% CI: 1.019-1.732, P = 0.036). Sensitivity analyses confirmed these findings' reliability. Reverse MR analysis showed no evidence of reverse causation between UF, OC, and Lachnospiraceae. This study establishes a causal relationship between Lachnospiraceae relative abundance and both UF and OC. These findings provide new insights into the potential role of gut microbiota in mechanisms underlying gynecological tumors development.

Pseudo-Meigs syndrome caused by a rapidly enlarging hydropic leiomyoma with elevated CA125 levels mimicking ovarian malignancy: a case report and literature review

Pseudo-Meigs syndrome is a rare syndrome characterized by hydrothorax and ascites associated with pelvic masses, and patients occasionally present with elevated serum cancer antigen-125 (CA125) levels. Hydropic leiomyoma (HLM) is an uncommon subtype of uterine leiomyoma characterized by hydropic degeneration and secondary cystic changes. Rapidly enlarging HLMs accompanied by hydrothorax, ascites, and elevated CA125 levels may be misdiagnosed as malignant tumors. Here, we report a case of HLM in a 45-year-old Chinese woman who presented with ascites and hydrothorax. Preoperative abdominopelvic CT revealed a giant solid mass in the fundus uteri measuring 20 × 15 × 12 cm. Her serum CA125 level was elevated to 247.7 U/ml, while her hydrothorax CA125 level was 304.60 U/ml. The patient was initially diagnosed with uterine malignancy and underwent total abdominal hysterectomy and adhesiolysis. Pathological examination confirmed the presence of a uterine hydropic leiomyoma with cystic changes. After tumor removal, the ascites and hydrothorax subsided quickly, with no evidence of recurrence. The patient’s serum CA125 level decreased to 116.90 U/mL on Day 7 and 5.6 U/mL on Day 40 postsurgery. Follow-up data were obtained at 6 months, 1 year, and 2 years after surgery, and no recurrence of ascites or hydrothorax was observed. This case highlights the importance of accurate diagnosis and appropriate management of HLM to achieve successful outcomes.

The role of VEGF and TGF-β blood levels for fibroid shrinkage, menorrhagia score, and quality of life improvement after uterine artery embolization for uterine fibroids: a study protocol.

Uterine leiomyoma is a common condition affecting women that occurs in more than 70% of females. Women with leiomyomas overall have lower quality of life and deficiency in many specific spheres of life including work-related productivity, sexuality, relationships, social-emotional health, and physical well-being that might be present even in pre-and extended throughout early postmenopausal life. Choices for symptomatic fibroid management include medical, interventional radiology procedures, surgical, and expectant management. The uterine artery embolization (UAE) procedure has gained justified popularity for myoma management. Growth factors, vascular endothelial growth factor (VEGF) and tumor growth factor β (TGF-β), hold an important role in leiomyoma progression. However, blood levels of VEGF and TGF-β in patients before and after UAE are not fully investigated and the possible relationship with myoma shrinkage has not been evaluated. Therefore, this study aims to assess menorrhagia score and quality of life improvement after UAE for uterine fibroids and compare blood levels of VEGF and TGF-β in patients with uterine leiomyoma before and after UAE. This cross-sectional study will be performed at the University Medical Center, Astana, Kazakhstan. Women undergoing the UAE procedure for uterine leiomyoma will be involved in the study following the precisely defined inclusion/exclusion criteria. Uterine leiomyoma nodules' structural changes after UAE will be assessed along with the blood levels of growth factors (VEGF and TGF-β), menorrhagia score, and quality of life. An important outcome of this project will be an investigation of the blood levels of growth factors (VEGF and TGF-β) before and after the procedure and their association with leiomyoma shrinkage in correlation with the menorrhagia score and quality of life alterations among patients undergoing UAE.

A novel scoring system based on magnetic resonance imaging for the prediction of the difficulty of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids

Objective To develop a novel scoring system based on magnetic resonance imaging (MRI) for predicting the difficulty of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids. Materials and methods A total of 637 patients with uterine fibroids were enrolled. Sonication time, non-perfused volume ratio (NPVR), and ultrasound energy delivered for ablating 1 mm3 of fibroid tissue volume (E/V) were each classified as three levels and assigned scores from 0 to 2, respectively. Treatment difficulty level was then assessed by adding up the scores of sonication time, NPVR and E/V for each patient. The patients with score lower than 3 were categorized into low difficulty group, with score equal to or greater than 3 were categorized into high difficulty group. The potential predictors for treatment difficulty were compared between the two groups. Multifactorial logistic regression analysis model was created by analyzing the variables. The difficulty score system was developed using the beta coefficients of the logistic model. Results Signal intensity on T2WI, fibroid location index, largest diameter of fibroids, abdominal wall thickness, homogeneity of the signal of fibroids, and uterine position were independent influencing factors for the difficulty of USgHIFU for uterine fibroids. A prediction equation was obtained: difficulty score = 17 × uterine position (anteverted =0, retroverted =1)+71 × signal intensity (hypointense = 0, isointense/hyperintense = 1) +8 × enhancement (homogenous = 0, heterogeneous = 1)+25×(largest diameter of fibroids-20) +35 × (fibroid location index −0.2) +1×(abdominal wall thickness −5). Conclusions This scoring system established based on MRI findings can be used to reliably predict the difficulty level of USgHIFU treatment of uterine fibroids.

The effect of surgical access on functional and oncological results of resections in laryngeal cancer T2N0M0

Introduction. Laryngeal cancer is the most common malignant neoplasm of the ENT organs. The preferred and primary therapy for this pathology is surgical intervention. The search for highly effective organ-saving methods of surgical treatment aimed at minimization of resection volume and preservation of functioning of the larynx continues. Current endolaryngeal surgery allows to improve functional results and is the most modern and advanced method.Aim. To compare functional and oncological results of surgical treatment of patients with laryngeal squamous cell carcinoma Т2N0M0 performed through transcervical and endolaryngeal accesses.Materials and methods. The results of surgical treatment of patients with squamous cell carcinoma of the vocal folds part of the larynx T2N0M0 performed between 2015 and 2020 at the Oncological Division of Head and Neck Tumors of the The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia were analyzed. The study included 49 men aged 52–72 years; the diagnosis was confirmed by histological examination. All patients underwent standard exams which led to diagnosis per the Tumor, Nodus and Metastasis international system.Results. Three-year recurrence-free survival after endolaryngeal resection of cancer of the vocal folds part of the larynx Т2N0M0 was 88.47 %, after transcervical resections it was 91.31 %. Analysis of functional and surgical results showed that compared to patients who underwent surgery through external access, in patients who underwent surgery with endolaryngeal access the rate of complications associated with the surgical wound in the early postoperative period was 13.04 % lower, frequency of cicatricial stenoses of the larynx was 20.06 % lower, and abnormalities of separating function of the larynx were 49.33 % rarer.Conclusion. In patients who underwent endolaryngeal resection of the larynx, better functional and surgical results were achieved compared to patients who underwent surgery through external access. Moreover, there was no statistically significant difference in oncological results between the study groups. This allows to conclude that minimally invasive endolaryngeal approaches are highly effective and functional in organ-saving surgeries for patients with squamous cell carcinoma of the vocal fold part of the larynx T2N0M0.

Risk Factors and Prediction Nomogram of Local Regeneration After Ultrasound-Guided Microwave Ablation of Uterine Fibroids

To explore the risk factors associated with uterine fibroids (UFs) local regeneration of the treated UFs after microwave ablation (MWA) and to develop a nomogram model for predicting the risk of local regeneration. Retrospective study. The Eighth Affiliated Hospital of Sun Yat-sen University. Patients with UFs who underwent MWA at our hospital between October 2020 and April 2023 were included. MWA was used for the treatment of UFs. A total of 47 patients with 68 fibroids were included into this study. Over a median follow-up of 13 months (interquartile range: 8 to 22 months), local regeneration occurred in 11 UFs. The clinical and imaging characteristics of these patients were recorded and compared. Risk factors for local regeneration were determined through univariate and multivariate Cox regression analysis. Multivariate analysis revealed that the fertility desires, larger size of UFs (≥95.3cm3) and hyper-enhancement of UFs on contrast-enhanced ultrasound (CEUS) were independent risk factors for local regeneration after MWA. A predictive nomogram was constructed to predict the local regeneration after MWA of UFs. The concordance index (C-index = 0.924, internal validation C-index = 0.895) and the 1-year and 2-year area under the curve (AUC) values (0.962, 0.927) all indicated that the nomogram had good predictive performance. Calibration and decision curve analysis (DCA) curves further confirmed the model's accuracy and clinical utility. Fertility desires, larger size of UFs and hyper-enhancement on CEUS were independent predictors of UFs local regeneration after MWA in our study. The nomogram constructed based on the above independent risk factors may help predict which UFs will develop local regeneration after MWA.

Changes in symptom burden and quality of life among women with uterine fibroids receiving relugolix combination therapy: a plain language summary.

This is a summary of findings from two research studies (known as clinical trials). The studies looked at how well a medicine called relugolix combination therapy worked in women with heavy menstrual bleeding (heavy bleeding during a period) with uterine fibroids (noncancerous or benign growths in the uterus). In this analysis of the studies, researchers looked at how patients self-reported their uterine fibroid symptoms before and after taking relugolix combination therapy. Researchers also looked at how patients self-reported the impact of uterine fibroids on their health-related quality of life before and after taking relugolix combination therapy. Women took either relugolix combination therapy or placebo (a pill that contains no medicine) by mouth once daily for 24weeks. Women completed the Uterine Fibroid Symptom and Quality of Life questionnaire (where "quality of life" refers to the women's health-related quality of life related to uterine fibroids) before, during, and after treatment. The questionnaire let researchers see if the women felt that relugolix combination therapy decreased the burden of uterine fibroid symptoms and improved the women's health-related quality of life related to uterine fibroids. More women said that they felt less distress due to their uterine fibroid symptoms and that their health-related quality of life related to uterine fibroids was better after taking relugolix combination therapy compared with women who took placebo. Relugolix combination therapy may lessen distress associated with uterine fibroid symptoms and improve health-related quality of life related to uterine fibroids.

Uterine fibroids: current research on novel drug targets and innovative therapeutic strategies.

Uterine fibroids, the most common nonmalignant tumors affecting the female genital tract, are a significant medical challenge. This article focuses on the most recent studies that attempted to identify novel non-hormonal therapeutic targets and strategies in UF therapy. This review covers the analysis of the pharmacological and biological mechanisms of the action of natural substances and the role of the microbiome in reference to UFs. This study aimed to determine the potential role of these compounds in UF prevention and therapy. While there are numerous approaches for treating UFs, available drug therapies for disease control have not been optimized yet. This review highlights the biological potential of vitamin D, EGCG and other natural compounds, as well as the microbiome, as promising alternatives in UF management and prevention. Although these substances have been quite well analyzed in this area, we still recommend conducting further studies, particularly randomized ones, in the field of therapy with these compounds or probiotics. Alternatively, as the quality of data continues to improve, we propose the consideration of their integration into clinical practice, in alignment with the patient's preferences and consent.

Perception and Health Care Seeking Behaviors of Women with Uterine Fibroids

Perception and Health Care Seeking Behaviors of Women with Uterine Fibroids

Racial Disparities in Surgical Treatment of Uterine Fibroids During the COVID-19 Pandemic.

Objective: Analyze the association between race and surgery performed for uterine fibroids during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Retrospective exploratory cross-sectional study of patients with fibroids who underwent surgery during the COVID-19 pandemic. We compared the type of surgery performed (minimally invasive hysterectomy [MIH], uterine-sparing procedure [USP], or total abdominal hysterectomy [TAH]) by White versus non-White patients. Absolute percentage differences were estimated with multinomial logistic regression adjusting for age, body mass index (BMI), parity, comorbidities, and maximum fibroid diameter. Results: Of 350 subjects, the racial composition was 1.7% Asian, 23.4% Black, and 74.9% White. Non-White patients had greater fibroid burden by mean maximum fibroid diameter, mean uterine weight, and mean fibroid weight. Although MIH occurred more frequently among White patients (7.5% points higher [95% confidence interval (CI) = -3.1 to 18.2]), USP and TAH were more commonly conducted for non-White patients (3.4% points higher [95% CI = -10.4 to 3.6] and 4.2% points higher [95% CI = -13.2 to 4.8], respectively). The overall complication rate was 18.6%, which was 6% points lower (95% CI = -15.8 to 3.7) among White patients. Conclusion: During the COVID-19 pandemic at a single-site institution, non-White patients were more likely to undergo a uterine-sparing procedure for surgical treatment of uterine fibroids, abdominal procedures, including both hysterectomy and myomectomy, and experience surgery-related complications.

Near-Infrared Imaging for Better Identifying the Cleavage Plane Between the Uterine Fibroid and its Pseudocapsule

Near-Infrared Imaging for Better Identifying the Cleavage Plane Between the Uterine Fibroid and its Pseudocapsule

Accuracy of the Measurement of Uterine Leiomyoma by Transabdominal Ultrasonography.

Introduction Uterine leiomyoma is a benign smooth muscle tumor. It does not necessarily require curative treatment, but if conservative management is chosen, it is important to rule out uterine leiomyosarcoma. When a size increase is observed, one must consider malignancy, and thus objective and cost-effective measurement of uterine size is important, especially for early detection of malignant change. Although MRI imaging is thought to be the gold standard for the diagnosis of uterine leiomyosarcoma, frequent MRI is impractical because of the incidence of uterine leiomyoma and the economic burden in real-world clinical practice. On the other hand, ultrasonography (US) is considered the most useful device in the observation of size changes. So this study aimed to examine the accuracy of the measurement of transabdominal US compared to MRI imaging. Materials and methods This retrospective study included 92 patients withuterine myoma ≥ 50 mm who undertook an MRI within 30 days after the transabdominal US. The longest diameter of the largest myoma (a), the longest diameter perpendicular to a in the sagittal image (b), and the longest diameter perpendicular to a and b in the axial image (c) were measured by US and MRI, and these were used to calculate the volume. Results were analyzed by intraclass correlation coefficient (ICC) 3.1. Results The ICC for the volume and major axis of the largest myoma by US and MRI were 0.87 and 0.90, respectively. The 95% confidence intervals (CI) were 0.82-0.91 and 0.87-0.93, respectively. Both reliability levels ranged from good to excellent. ICC was 0.54 (95%CI 0.15-0.78) in myomas with a volume of >500 cm3, and the concordant rate between US and MRI was poor to good. On the other hand, ICC was 0.82 (95%CI 0.57-0.93) even though all myomas with major axes greater than 120 mm had a volume >500 cm3, and the concordant rate between US and MRI measurements was moderate to excellent. In the evaluation by major axis, ICC was 0.60 (95%CI -0.41-0.95) for myomas larger than 160 mm, indicating a lower concordant rate. Conclusion Transabdominal US is an appropriate modality as well as MRI for follow-up of uterine myoma size if the nodules are 160 mm or smaller. Measurement of the major axis is easier and more useful than volume.

Pulmonary benign metastasizing leiomyoma presenting as acute hypoxemic respiratory failure: a case report

Pulmonary benign metastasizing leiomyoma is an uncommon condition, predominantly affecting women of childbearing age with a history of uterine smooth muscle tumors and uterine leiomyoma surgery for uterine leiomyoma. The progression of PBML is often unpredictable and depends on the extent of lung involvement. Generally, most patients remain asymptomatic, but a minority may experience coughing, wheezing, or shortness of breath, which are frequently misdiagnosed as pneumonia. consequently, this presents significant challenges in both treatment and nursing care before diagnosis. This paper reports the case of a 35-year-old woman primarily diagnosed with acute hypoxic respiratory failure who was transferred from the emergency room to the intensive care unit. The initial computed tomography scan of the patient’s lungs indicated diffuse interstitial pneumonia, but the sequencing of the alveolar lavage fluid pathogen macro did not detect any bacteria, fungi, or viruses. Moreover, the patient remained in a persistent hypoxic state before the definitive diagnosis. Therefore, our focus was on maintaining the airway patency of the patient, using prone ventilation, inhaling nitric oxide, monitoring electrical impedance tomography, and preventing ventilator-associated pneumonia to improve oxygenation, while awaiting immunohistochemical staining of the patient’s biopsied lung tissue. This would help us clarify the diagnosis and treat it based on etiology. After meticulous treatment and nursing care, the patient was weaned off the ventilator after 26 days and transferred to the respiratory ward after 40 days. This case study may serve as a reference for clinical practice and assist patients suffering from PBML.

Incidental Tubal Dermoid During Laparoscopic Hysterectomy for Uterine Fibroids: A Case Report

Incidental Tubal Dermoid During Laparoscopic Hysterectomy for Uterine Fibroids: A Case Report

Hongjin Xiaojie Capsule, a Chinese patent medicine, for treating moderate to severe cyclical breast pain: A single-blind randomized controlled trial

BackgroundModerate to severe breast pain has major effects on the quality of life for patients. Patent Chinese medicines are widely used in the treatment of breast pain due to their stable dosage form and good efficacy. ObjectiveTo evaluate the beneficial effects and safety of Hongjin Xiaojie Capsule (HJXJC), a Chinese patent medicine, for the treatment of cyclical breast pain. Design, setting, participants and interventionThis is a multicenter, single-blind randomized controlled trial conducted in 3 medical centers in China from 2019 to 2021. Patients with moderate to severe cyclic breast pain were randomly divided into the intervention group (who took HJXJC, four capsules per dose, three times a day for 12 weeks) and the control group (waiting for the treatment) in a 1:1 ratio. Main outcome measuresThe primary outcome was pain duration, and the patients recorded measurements at baseline and at the end of weeks 4, 8, 12 and 16 on a patient log card. ResultsThe full analysis set (FAS) population included 298 participants (intervention group, n = 150; control group, n = 148), while the per-protocol analysis set (PPS) included 274 participants. After 12 weeks, the duration of breast pain was significantly shorter in the intervention group (FAS: mean difference, –6.69; 95% CI, –7.58 to –5.80; P < 0.01, vs control. PPS: mean difference, –7.09; 95% CI, –8.01 to –6.16; P < 0.01, vs control). The Short-form McGill Pain Questionnaire (SF-MPQ) scores were significantly lower in the intervention group (FAS: mean difference, –12.55; 95% CI, –13.90 to –11.21; P < 0.01, vs control. PPS: mean difference, –13.07; 95% CI, –14.48 to –11.66; P < 0.01, vs control). The above indicators continued to be significantly different through week 16. Moreover, in the intervention group, breast lumps shrank after 12 weeks and the size of breast lumps was statistically smaller than that in the control group (P < 0.05), whereas the sizes of breast nodules and uterine fibroid showed no statistically significant difference compared with the control group (P > 0.05). At weeks 8 and 12, the dysmenorrhea scores in the intervention group were lower than those in the control group (P < 0.05). No obvious adverse reactions were observed in any group. ConclusionHJXJC can significantly shorten the duration of breast pain, reduce breast pain, reduce the size of breast lumps, and relieve dysmenorrhea. However, it has no significant effect on the size of breast nodules or uterine fibroid. Trial registrationThis trial has been registered at the ISRCTN Registry. Number: ISRCTN44184398. Please cite this article asZhang Q, Fan YY, Wu XQ, Huo YD, Wang CH, Liang SB, Wang T, Zhong R, Wang X, Lai BY, Pei XH, Liu JP. Hongjin Xiaojie Capsule, a Chinese patent medicine, for treating moderate to severe cyclical breast pain: A single-blind randomized controlled trial. J Integr Med. 2024; 22(5): 552–560.

Molecular genetics and research progress of uterine leiomyosarcoma.

Uterine leiomyosarcoma (uLMS) is a type of malignant soft-tissue tumor, which is developed from myometrium in the female reproductive system. This disease is difficult to be distinguished from benign uterine leiomyoma in the early stages, but it progresses aggressively and relentlessly. Hence, uLMS has a dismal prognosis and high rates of both misdiagnosis and missed diagnosis. Unfortunately, current studies of uLMS pathogenesis and disease biology are inadequate. uLMS disease models are also very limited, hindering the development of effective therapeutics. In this review, we focus on the pathological molecular biology of uLMS, and systematically review the molecular genetic features, epigenetic variants, experimental models, and clinical research progress of uLMS. We further discuss the development direction and potential needs of uLMS in the fields of tumor evolution, tumor microenvironment, and tumor therapy, with the aim of providing a better understanding of the pathobiological mechanism of uLMS and providing a reference for the development of potential diagnostic and therapeutic strategies.

Evaluation of Latrogenic Genitourinary Fistula after Major Gynaecological Operation in Patient Group Admitted in BSMMU

Introduction: Close proximity of urinary tract and genital systems in females poses potential risk of fistulas formation during surgical interventions. Gynaecological malignancy, bleeding, prolonged surgery, the presence of active infection during operation, endometriosis, large uterus, previous pelvic operation, pelvic adhesions and myoma uteri are major predisposing factors that may increase the risk of urological injuries &amp; genitourinary fistulas. Genitourinary fistulas result in continuous or intermittent urinary incontinence and a significant public health issue with negative physical, emotional and social impacts on individuals. Materials and Methods: This cross sectional observational study was conducted in Department of Obstetrics &amp;Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from 27th March 2017 to 26th September 2017. The sample was collected by purposive sampling technique. The study subjects were women with iatrogenic fistula (diagnosed after a clinical examination and investigations) attended in out-patients or in-patients department. Result: Mean age of patients was 32.5 ± 9.54 years. Vesicovaginal fistula was commonest cause for iatrogenic genitourinary fistula, present in 34 patients. Ureterovaginal fistula was 10 patients and 6 patients detected urethrovaginal. Aetiological factors revealed that, 46.0% occurred during vaginal hysterectomy, 18.0% due to abdominal hysterectomy, 20.0% due to laparotomy with salphingoophorectmy and 16.0% during laparotomy with cystectomy. Conclusion: The commonest urogenital fistula is the vesicovaginal fistula. Urinary leakage following gynaecological surgery is a dreaded complication due to the formation of urogenital fistula. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical procedures. Medicine Today 2024, Vol.36 (2): 110-113

High-intensity focused ultrasound ablation in the treatment of fumarate hydratase-deficient uterine leiomyoma

Objective This study aimed to explore the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation for treating fumarate hydratase (FH)-deficient uterine leiomyomas. Method Ten patients with FH-deficient uterine leiomyomas treated with HIFU ablation at the Third Xiangya Hospital from July 2017 to January 2023 were enrolled in this study. The effectiveness and adverse effects of HIFU were analyzed. Results The median age of the patients who received HIFU was 32.0 years (range: 28–41 years). Only 2 patients had solitary uterine leiomyomas, whereas the remaining 8 patients had multiple uterine leiomyomas. The median diameter of the largest myoma was 56 mm (range: 41–99 mm). Magnetic resonance imaging showed that the FH-deficient uterine leiomyomas of 8 patients presented as mixed intensity on T2WI, that of one patient was hypointense, and that of another patient was hyperintense on T2WI. All patients successfully underwent HIFU ablation in one session without severe adverse effects. The median nonperfusion volume ratio (NPVR) was 40% (30.0%–78.0%) after HIFU treatment. Four patients had NPVR ≥70%. At 3-month follow-up after HIFU ablation, the clinical symptoms of 5 of the 8 patients with symptoms before treatment were relieved. Six months after treatment, 4 of the 8 patients with symptoms were still in remission. All patients received reintervention by March 2024. The reintervention rates were 20%, 70%, and 90% at 12, 24, and 36 months, respectively, after HIFU ablation. Conclusion HIFU is a safe and feasible treatment for FH-deficient uterine leiomyomas, and most patients show effective results in the short term after treatment. However, the reintervention rates are high, and the long-term effects are limited.

Analysis of the incidence of uterine fibroid in Yekaterinburg

Background. Uterine fibroid (UF) is a benign tumor of the myometrium and is considered as one of the criteria for the state of women’s reproductive health. Objective information about the incidence of UF in a modern megalopolis allows us to assess the level of health of the female population, characterize the availability and quality of medical care, and plan its development.Aim. To analyze the incidence and prevalence of UF according to the data of medical organizations in Yekaterinburg in 2016–2022.Materials and methods. An epidemiological study of the incidence and prevalence of the adult female population of the city of Yekaterinburg in 2016–2022 was conducted. For the analysis, we used Form No. 12 of the Federal Statistical Observation of Medical Organizations located in the city. The incidence rates were calculated for the average annual female population aged 18 years and over, expressed in 0/0000. Absolute growth (decrease), growth rate (decrease), growth rate (decrease), average growth rate (decrease) were studied. The long-term dynamics of the indicators was determined using the average growth rate.Results. The incidence of UF was 130.890/0000, and the prevalence was 735.800/0000 in 2016. During the pre-pandemic period, the indicators increased significantly in 2019 compared to the baseline year 2016 (р &lt; 0.001). The incidence increased by 1.96 times, the prevalence – by 1.39 times. The indicators decreased to the level of 2016 during the pandemic of new coronavirus infection (2020–2022) (р &gt;0.05).Conclusion. The obtained dynamics of incidence and prevalence of UF in the population of women in a modern megalopolis is considered as a criterion for the state of women’s health, accessibility and quality of preventive and planned medical care for gynecological patients. The results of the study are recommended for planning medical care for women and can form the basis for continuing epidemiological studies.

Dysregulation of ezrin expression and phosphorylation in Uterine Leiomyoma

Dysregulation of ezrin expression and phosphorylation in Uterine Leiomyoma