Uterine Fibroids Research Articles

Метод буккальных цитограмм для задач выделения групп риска развития миомы матки у работниц медеплавильного производства

Exposure to adverse occupational factors increases the risk of diseases of the reproductive system. Long-term studies have shown a high prevalence of uterine fibroids among all diseases of the reproductive system in women exposed to occupational hazards in industry. The occurrence of fibroids, having such complications as menorrhagia, pain in the pelvic area, and infertility, hampers performance and diminishes the quality of life. The risk of genetic mutations in cells playing a key role in the development of fibroids is raised by inhalation of industrial aerosols containing metals possessing mutagenic and carcinogenic potencies. Cytology of the buccal epithelium can be used as a method objectively indicating the genetic risk. The purpose of the study was to develop a predictive model for assessing the risk of uterine fibroids in female workers exposed to aerosols containing metal particles at a copper smelter using buccal cytograms. We examined 47 female workers of a copper smelter, of which 39 formed the main (exposed) group. Uterine fibroids were more frequent in the main group than in the controls (25.6 % versus 0.0 %, p ≤ 0.05). Genotoxic indicators, such as protrusions and micronuclei, and cytotoxicity indicators were also significantly increased in this group (nuclear vacuolization and cytoplasmic vacuolation were 1.6 times and karyolysis 1.8 times higher compared with the controls, p ≤ 0.05). We have developed two mathematical models for assessing the risk of uterine fibroids. Model 1 includes variables without restrictions of characteristics, i.e. micronuclei, perinuclear vacuoles, and cytoplasmic vacuolation (AUROC – 0.940), while Model 2 necessarily includes such genotoxic parameters as micronuclei and protrusions (AUROC – 0.883). The 4-member model (M1+M2), which includes both genotoxic (micronuclei and protrusions) and cytotoxic (binucleated cells and cytoplasmic vacuolation) indicators, has the highest significance (AUROC – 0.998). The results indicate involvement of both genetic and cytotoxic mechanisms in the development of uterine fibroids in female workers exposed to toxic industrial aerosols. The models including both two indicators of genotoxicity (micronuclei and protrusion) and one and/or two cytotoxicity indicators have the greatest predictive value.

Uterine fibroids: a narrative review of epidemiology and management, with a focus on uterine artery embolization

Uterine fibroids: a narrative review of epidemiology and management, with a focus on uterine artery embolization

Uterine fibroids & infertility: which fibroids should be removed?—a narrative review

Uterine fibroids & infertility: which fibroids should be removed?—a narrative review

Successful pregnancy outcome after sonographic control and gasless laparoscopic removal of 810-gram fibroid during pregnancy: case report.

The management of symptomatic uterine fibroids during pregnancy is a challenging situation. In some cases, surgical therapy can be required. Reports indicate that both laparotomy and laparoscopy are safe methods. However, laparoscopy is associated with less morbidity. This paper describes the case of a 31-year-old woman with a symptomatic uterine fibroid which was removed by gasless laparoscopy.

Reduction Of Uterine Fibroid Size Through Integrated Yoga And Naturopathy: A Case Report

This case study investigates the possible efficacy of Yoga and Naturopathy therapies for controlling uterine fibroids. A 51-year-old lady with a big subserous fibroid (64mm x 47mm) and symptoms of excessive bleeding and discomfort underwent a six-month treatment regimen that included Yoga, hydrotherapy, mud therapy, and dietary/lifestyle changes. Ultrasound revealed that the fibroid size (58mm x 40mm) had significantly shrunk following the intervention. This instance implies that Yoga and Naturopathy may have a role in the management of fibroids, presumably through their combined impact on inflammation, oxidative stress, and overall health. Further study with bigger cohorts is required to corroborate these results

Progress in the Search for an Effective Resorbable Embolic Material for Uterine Fibroid Embolization.

Progress in the Search for an Effective Resorbable Embolic Material for Uterine Fibroid Embolization.

An Updated Review of Thermal Ablation Technology for Uterine Fibroids and Adenomyosis: Focusing on Protecting Fertility.

There is a growing trend towards minimally invasive or noninvasive alternatives for gynecological disorders due to their rapid alleviation of symptom, expedited recovery, and minimal risks of postoperative complications. Thermal ablation technology has been commonly advocated as a minimally invasive therapeutic methods in recent years, including microwave ablation, radiofrequency ablation, and high-intensity focused ultrasound. The increasing application scenarios require updated and systematic research, and more evidence to promote their appropriate use. The objective of this review is to summarize the latest views of ablation from a prospective of fertility protection, endeavor to clarify the clinical value of thermal ablation technology in protecting fertility by assessing parameters such as ablation rates, alleviation of disease symptoms, re-intervention rates and post-treatment pregnancy rates. We review the clinical studies of ablation for uterine fibroids and adenomyosis treatment in the past 10 years, summarize the limitation and the prospects of its development in the treatment process, so as to provide clinicians with advice on the best practice. In the management of uterine fibroids and adenomyosis, thermal ablation technology offers improved fertility preservation and minimizes normal tissue injury compared to traditional surgical approaches for patients pursuing reproductive goals. In the future, thermal ablation technology will play a significantly enhanced role in preserving fertility for individuals requiring treatment for uterine fibroids and adenomyosis, guided by indications. But further research is still needed in the form of more extensive randomized prospective trials to provide stronger evidence supporting this perspective.

Interventional Radiology Awareness Among Family Physicians and General Practitioners in Jazan Region, Saudi Arabia.

Background Interventional radiology (IR) utilizes minimally invasive procedures guided by imaging to diagnose and treat various conditions, offering less invasive alternatives to traditional surgery. Despite its importance, awareness among family medicine practitioners can vary, affecting patient care. While IR has advanced in Saudi Arabia, there are limited data on family medicine practitioners' understanding of IR. This study assesses awareness of IR procedures among family medicine doctors in Jazan and their perceived need for further education. Methods A cross-sectional interview-administered survey was conducted online among family medicine doctors in Jazan via social media. The survey assessed demographic data, awareness of IR procedures, self-rated knowledge, and attitudes towards IR. Participants' understanding of IR training, hospital privileges, outpatient clinics, and recognition by the Saudi Commission for Health Specialties (SCHS) was evaluated. Data were analyzed using descriptive statistics and chi-square tests. Results Out of 395 respondents, the age distribution was as follows: 20-29 years (44.3%), 30-39 years (32.9%), and 40 years or older (22.8%). Gender distribution was as follows: females (44.6%) and males (55.4%). Specialties included family medicine consultants (10.6%), residents (32.4%), specialists (22.8%), and general practitioners (34.2%). Awareness of IR procedures varied: uterine fibroid embolization (58.7%), coronary angiography (57.5%), vascular angioplasty (63.5%), radiofrequency ablation (61.3%), peripheral vascular bypass (61.8%), brain biopsy (56.2%), nephrostomy tube placement (59.5%), varicose veins treatment (63.0%), and cystoscopic tumor resection (54.7%). Self-rated knowledge was as follows: poor (46.8%), adequate (27.1%), good (15.7%), and excellent (10.4%). Most believed that interventional radiologists' training was in radiology (62.8%), with fewer attributing it to vascular surgery (20.5%) or a combination (16.7%). Regarding privileges and facilities, 248 (62.8%) reported hospital admitting privileges for IRs, 251 (63.5%) reported outpatient clinics, and 45 (11.4%) were unsure about admitting privileges. SCHS recognition was confirmed by 267 (67.6%). Referrals to IRs were made by 283 (71.6%), and 260 (65.8%) would increase referrals with more knowledge. The perceived benefit of additional education was as follows: no benefit (48.4%), some benefit (30.6%), and significant benefit (21.0%). Conclusion The study reveals gaps in awareness and knowledge of IR among family medicine doctors in Jazan. While there is recognition of IR's value and a willingness to refer patients, variations in knowledge highlight the need for targeted educational interventions. Improving education on IR could enhance integration into patient care and optimize outcomes.

Feasibility and safety evaluation of ultra-remote robot-assisted laparoscopic hysterectomy

ObjectiveTo assess the safety and feasibility of ultra-remote robot-assisted laparoscopic hysterectomy using the Edge Multi-Port Endoscopic Surgical Robot MP1000 (Shenzhen Edge Medical Co., Ltd., Shenzhen, China) combined with 5G communication technology. MethodsA case of remote robot-assisted laparoscopic hysterectomy was successfully completed on May 2024 by using the Edge Multi-Port Endoscopic Surgical Robot MP1000 at Zhongnan Hospital of Wuhan University and the People's Liberation Army General Hospital, approximately 1, 200 ​km apart. The procedure was simultaneously broadcast during the 36th Annual Meeting of the International Society for Gynecologic Endoscopy in Conjuction with the Peking University Gynecologic Oncology Summit Forum. ResultsA 49-year-old female was hospitalized in the Department of Gynecology of Zhongnan Hospital of Wuhan University for frequent urination for half a year and increased menstrual flow for over a month. The patient was diagnosed with abnormal uterine bleeding caused by multiple uterine leiomyoma and endometrial polyps, combined with moderate anemia. There were no contraindications for surgery, and the patient had surgical indications. On May 2024, the patient underwent a 5G remote robot-assisted laparoscopic hysterectomy and bilateral salpingectomy under general anesthesia. The procedure was successful, with no surgical complications and no interruptions during the live broadcast. The intraoperative blood loss was approximately 20 ​mL, and the surgery lasted about 70 ​min. The bidirectional latency during the operation was around 19 ​ms, with no adverse events related to the robot or the network. The patient recovered well postoperatively and was discharged on the fourth day with no postoperative complications. ConclusionPreliminary findings indicate that ultra-remote robot-assisted laparoscopic hysterectomy is safe and feasible with the support of 5G communication technology. This surgery represents the first globally broadcast remote procedure in the field of gynecology, marking a new milestone in the stability and safety of China's remote medical technology. Remote robotic surgery is expected to be widely promoted in the future, providing services to patients in areas with limited medical resources.

Clinical characteristics and treatment outcomes of angioleiomyoma of the female genital tract: a retrospective cohort study

BackgroundAngioleiomyoma, a benign tumour composed of smooth muscle cells and thick-walled vessels, is expected to be very rare in the female genital tract. This study aimed to describe the clinicopathological features and treatment outcomes of angioleiomyoma in the female genital tract.MethodsWe retrospectively reviewed 89 women with angioleiomyoma in the genital tract who were treated at Third Xiangya Hospital of Central South University between July 2008 and October 2023. Symptom remission rate was the primary outcome of the study.ResultsAngioleiomyomas accounted for 0.6% of leiomyomas of the female genital tract. The average age of the 89 women was 41.8 ± 8.7 years. Seventy women (78.7%) had a history of uterine surgery, of whom two patients had removed uterine angioleiomyoma by laparoscopic myomectomy. The angioleiomyomas of 61 (68.5%) women were located in the uterine corpus, 17 (19.1%) in the broad ligament, 10 (11.2%) in the cervix and only 1 (1.1%) in the vagina. Abnormal uterine bleeding was the main clinical manifestation of angioleiomyomas located in the uterine corpus or cervix, whereas the main clinical manifestation of angioleiomyomas in the broad ligaments was pelvic mass. Of the 89 women, 59 underwent surgery to preserve the uterus, and 30 underwent total hysterectomy or subtotal hysterectomy. The intraoperative blood loss was more than 500 ml (700–4,500 ml) in six women. The symptom remission rate was 100% after surgery. Among the 59 women with preserved uterus, 8 showed multiple uterine leiomyomas during follow-up, but it was difficult to determine whether they were angioleiomyomas. Angioleiomyomas recurred in one women who underwent total hysterectomy.ConclusionAngioleiomyoma is rare in the female reproductive tract, and patients may present with diverse symptoms, which are related to the location of the tumour. Hysterectomy and myomectomy are both effective treatment methods, but the risk of intraoperative bleeding should be recognised for multiple lesions and those with large diameters. Relapse may occur in some patients.

LOCAL IMMUNE STATUS OF PATIENTS AFTER HYSTEROSCOPIC MYOMECTOMY AND METHODS OF ITS CORRECTION

Aim. To evaluate changes in the local immune status of women after hysteroscopic myomectomy and the effect of the proposed treatment complex on them. Materials and methods. 221 patients with submucous uterine myoma who underwent hysteroscopic myomectomy were examined. 121 patients of the main group in the semi-operative period received complex rehabilitation therapy, 100 patients of the comparison group did not receive additional treatment after surgery. 80 women who applied for a routine preventive examination formed the control group. In all patients, the content of factors of local immunity – IL-6, IL-10, lactoferrin and secretory inhibitor of leukocyte proteinase in cervical mucus was studied by enzyme-linked immunosorbent assay (ELISA) using Atiscare reagents in the laboratory conditions of the Center. The indicators were studied before surgery, 3 and 6 months after surgery. Results. In patients with submucosal uterine myoma, an increased content of pro-inflammatory IL-6 in cervical mucus was found (357.9 pg/ml and 345.3 pg/ml), in the control group 134.7 pg/ml and a decrease in the concentration of anti-inflammatory IL-10 (37 .6 pg/ml and 34.3 pg/ml) while the value of the control group was 78.5 pg/ml. The increase in the cervical content of the secretory inhibitor of leukocyte proteinase in women with submucous uterine myoma (274.2 pg/ml and 284.9 pg/ml against 114.5 pg/ml in the control group) is evidence of an active reaction of the mucous membrane to the inflammatory process. The role of the factor in the implementation of antisperm immunity is a factor of impaired fertility in such women. Elevated lactoferrin (27.4 ng/ml and 28.4 ng/ml vs. 3.5 ng/ml in healthy women) is also associated with infertility. Performing hysteroscopic myomectomy leads to a gradual, but incomplete normalization of the content of the specified immune factors in the cervical mucus, and the improvement of the treatment complex leads to the full achievement of the indicator of the control group after 6 months, which is important for the implementation of reproductive function. Conclusions. 1. Patients with submucous uterine myoma are characterized by an increased content of pro-inflammatory factors of local immunity – IL-6, lactoferrin and secretory inhibitor of leukocyte proteinase, as well as a reduced concentration of anti-inflammatory IL-10. 2. After hysteroscopic myomectomy for 6 months, there is a decrease in the content of pro-inflammatory factors and an increase in the concentration of IL-10 in the cervical mucus, but the indicators do not reach the values of healthy women. 3. The use of the proposed complex of treatment after hysteroscopic myomectomy allows to achieve faster changes in the indicators of local cervical immunity, and after 6 months to achieve the values obtained in healthy women.

Persistent endocrine-disrupting chemicals and incident uterine leiomyomata: A mixtures analysis

BackgroundUterine leiomyomata (UL; fibroids) are hormone-dependent neoplasms that can cause significant gynecologic morbidity. Studies have documented associations between concentrations of persistent endocrine-disrupting chemicals (EDCs) and UL incidence; however, few have assessed the effects of EDC mixtures on UL. MethodsIn the Study of Environment, Lifestyle, and Fibroids, a prospective cohort study, participants attended study visits at baseline and approximately every 20 months for up to 10 years; at each visit, they completed questionnaires, provided blood samples, and underwent standardized ultrasound examinations. In baseline plasma samples (n = 1155), we quantified concentrations of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides using high-resolution mass spectrometry. We selected nine EDCs detected in >60 % of samples (4 PCBs, 4 PBDEs, and 2,2-bis(4-chlorophenyl)-1,1-dichloroethene (p,p’-DDE)) and conducted probit Bayesian kernel machine regression with hierarchical variable selection to estimate effects of the EDC mixture and individual EDCs on UL incidence, adjusting for potential confounders. ResultsDuring 10 years of follow-up, 32 % of participants developed ultrasound-detected UL. The EDC mixture was not appreciably associated with the probit of UL (β comparing all EDCs at their 75th vs. 50th percentile:= − 0.01, 95 % credible interval [CrI]: −0.11, 0.10). However, individual EDC concentrations were associated with UL in opposing directions: PCB138/158 was positively associated with UL (β for 25th-to-75th-percentile increase when all other chemicals were set to their 50th percentile = 0.18, 95 % CrI: −0.09, 0.44), whereas PBDE99 and p,p’-DDE were inversely associated with UL (β = −0.06, 95 % CrI: −0.21, 0.10 and β = −0.12, 95 % CrI: −0.34, 0.10, respectively). There was little evidence of interaction between EDCs. ConclusionIn this prospective ultrasound study, a mixture of persistent EDCs was not appreciably associated with incident UL during 10 years of follow-up, but individual EDCs were associated with UL in opposite directions.

Endometrial E-cadherin and N-cadherin Expression during the Mid-Secretory Phase of Women with Ovarian Endometrioma or Uterine Fibroids.

Endometriosis and uterine fibroids are benign conditions frequently linked to subfertility/infertility. Recent research has highlighted the importance of epithelial-mesenchymal transition between embryonic and endometrial cells in the context of embryo implantation. Additionally, the adverse endometrial environment during implantation has been proposed as a mechanism contributing to infertility in endometriosis. Nevertheless, the role of cadherin molecule alterations in relation to endometrial receptivity and embryo invasion remains a subject of controversy. We investigated the expression patterns of E-cadherin and N-cadherin in the endometria of women with ovarian endometrioma or uterine fibroids and assessed whether they differed from those of healthy women. We enrolled 17 women with ovarian endometrioma, 16 with uterine fibroids, and 6 healthy women. Endometrial tissues were obtained at the mid-secretory phase on days 19-24 of the menstrual cycle. The E-cadherin and N-cadherin mRNA and protein expression levels were measured using quantitative reverse transcriptase polymerase chain reaction and Western blot analysis, respectively. The E-cadherin and N-cadherin mRNA expression levels were higher and lower, respectively, in the endometrium of women with ovarian endometrioma than in those of the controls. In the endometrium of women with uterine fibroids, similar patterns with higher E-cadherin and lower N-cadherin levels were observed compared with that of the controls. Protein expression showed similar patterns. Our findings revealed higher E-cadherin expression and lower N-cadherin expression in the endometria of women with infertility-related diseases than in those of healthy women in the mid-secretory phase. This suggests a resistance to endometrial receptivity, potentially reflecting mesenchymal-epithelial transition properties.

Uterine Fibroids, Variants, Mimics: Imaging Findings

Uterine Fibroids, Variants, Mimics: Imaging Findings

Monogram and Heat Map on Magnetic Resonance Imaging to Evaluate the Recommendation for Myomectomy in Patients with Infertility: A Pilot Study.

Uterine myomas can cause infertility. Studies are attempting to determine the indications for myomectomy. However, the multiplicity and localization of myomas complicate this issue. We aimed to develop a visualization tool to aid patients with infertility in their decision-making for myomectomy. We included 191 women with uterine myoma attending an outpatient infertility clinic, of whom 124 patients underwent myomectomy. Of these, 65 (52.4%) patients became pregnant within 17.6 months after surgery, and 54 (83.1%) of them had a live birth. A logistic regression model predicting the pregnancy rate (area under the curve, 0.82; 95% confidence interval, 0.74-0.89; validation value, 74.6%) was generated using the leave-one-out cross-validation method. This model incorporated five factors: age, maximum level of infertility intervention following myomectomy, presence of submucosal myoma, maximum diameter of the myoma, and type of myomas (multiple or single). We successfully visualized the degree of involvement of each factor in the pregnancy rate by developing a nomogram based on this model. We expanded the data from the preoperative magnetic resonance images and applied machine learning using a convolutional neural network. The classification accuracy was 71.4% for sensitivity and 77.7% for specificity. Heatmap images, generated using gradient-weighted class activation mapping to show the classification results of this model, could distinguish between myomas that required enucleation and those that did not. Although a larger sample size is needed to further validate our findings, this innovative pilot study demonstrates the potential of machine learning to refine assessment criteria and improve patient decision-making.

Outcome of Pregnancy In Myomatous Uterus in the Gynecology-Obstetrics Department of the Ignace Deen Hospital of the Conakry University Hospital Centre, Guinea

Introduction: the association of myoma and pregnancy is a frequent entity, often prone to obstetric complications. The aim of this study was to analyse the impact of myoma on pregnancy, childbirth and the post-partum period. Patients and methods: this was a prospective descriptive and analytical study conducted over a 6-month period from 6 September 2022 to 5 March 2023 in the gynaecology and obstetrics department of Ignace Deen Hospital. It concerned pregnant women with uterine myomas who had agreed to take part in the study. Results: the frequency of pregnancy in a myomatous uterus was 5.58%. The average age of the pregnant women was 28, with extremes of 21 and 40. The most common age group was 31-35. Nearly 70% (69.86%) of the cases of fibroids associated with pregnancy were discovered by ultrasound. The location of the myomas was interstitial in 47.95% of cases. Medium-sized fibroids (6-10 cm) dominated our series (53.42% of cases). Of the 146 cases collected, 72% gave birth in the department, 77.78% by caesarean section. The indication for caesarean section Dystocic presentations (54.76%) were the major indication in more than half the cases. Over 70% of pregnant women gave birth without complications. These were dominated in the mother by miscarriage (20.93%) and premature delivery (16.27%). Fetal asphyxia (4.65%) and intrauterine growth retardation (4.65%) in the fetus. The study reported a significant association between size, location and the occurrence of obstetric complications (P value: 0.034; 0.009). Conclusion: the association of fibroma and pregnancy is a frequent entity and constitutes a high risk for the mother and the foetus. Morbidity is related to the location of the myoma and changes according to the term of the pregnancy. If pregnancy is to have a successful outcome, it is essential that pregnant women are aware of the importance of antenatal monitoring, with a view to early detection and appropriate management of any complications.

RISK FACTORS OF LOW PLACENTATION

The purpose of the study – to assess the risk factors for the occurrence of low placentationin the early stages of gestation.Materials and methods. A clinical and statistical analysis of 150 individual charts ofpregnant women and women in labor in women with a low lying placenta (main group)and 80 pregnant women with a normal localization of the placenta in the fundus andbody of the uterus (control group), who were under dispensary supervision in a women’sconsultation, was carried ou.tThe results. After conducting the analysis, it was established that the main groupwas dominated by women over 30 years old (40.7 % of cases), compared to 25.0 %of pregnant women in the control group (p<0.05). The age of onset of menarche after14 years is marked significantly more often in pregnant women with low placentation –in 22.7 %, compared to normal localization of the placenta – in 8.8 % of cases. Thedevelopment of the menstrual cycle by one year in the main group was 2.5 times lessfrequent than in the control group. 58.7 % of pregnant women with low placentationhad 2 or more artificial abortions, 46 % had a history of spontaneous miscarriages, inpregnant women with normal placentation, these indicators were 32.5 % and 18.8 % ofpregnant women, respectively (p<0.05). In 20.7 % of cases of women in the main group,childbirth was completed by cesarean section, and in the control group – in 7.5 % ofcases. In pregnant women with low placentation, 26.0 % had inflammatory diseases ofthe uterine appendages, 50.7 % had cervical erosion, 10.7 % had uterine fibroids, 16.7 %had endometriosis, compared to the control group in 17 .5 %, 36.3 %, 3.8 % and in 6.3 %of cases, respectively (p<0.05). Conservative myomectomy was performed in 30 % ofcases of the main group and 12.5 % of women in the control group. Conclusions. Risk factors for low placentation are a woman’s age over 30 years, latemenarche and late onset of menstrual function, history of gynecological diseases, highbirth parity, history of spontaneous miscarriages and artificial abortions, uterine scar,and manual revision of the uterine cavity walls. Identifying the risk factors for lowplacentation will reduce the level of perinatal and obstetric complications.

Somatic MED12 Mutations in Myometrial Cells.

Over 70% of leiomyoma (LM) harbor MED12 mutations, primarily in exon 2 at c.130-131 (GG). Myometrial cells are the cell origin of leiomyoma, but the MED12 mutation status in non-neoplastic myometrial cells is unknown. In this study, we investigated the mutation burden of MED12 in myometrium. As traditional Sanger or even NGS sequencing may not be able to detect MED12 mutations that are lower than 0.1% in the testing sample, we used duplex deep sequencing analysis (DDS) to overcome this limitation. Tumor-free myometria (confirmed by pathology evaluation) were dissected, and genomic DNA from MED12 exon 2 (test) and TP53 exon 5 (control) were captured by customer-designed probe sets, followed by DDS. Notably, DDS demonstrated that myometrial cells harbored a high frequency of mutations in MED12 exon 2 and predominantly in code c.130-131. In contrast, the baseline mutations in other coding sequences of MED12 exon 2 as well as in the TP53 mutation hotspot, c.477-488 were comparably low in myometrial cells. This is the first report demonstrating a non-random accumulation of MED12 mutations at c.130-131 sites in non-neoplastic myometrial cells which provide molecular evidence of early somatic mutation events in myometrial cells. This early mutation may contribute to the cell origin for uterine LM development in women of reproductive age.

Uterine fibroids and Black people of African descent globally: a scoping review protocol.

Evidence suggests that when adjusted for age and other factors such as Body Mass Index, age of first pregnancy, years since last pregnancy and alcohol consumption, Black women are three times more likely to suffer from fibroids compared with the general population. When compared with the general population, Black women experience larger uterine fibroids with an earlier onset and more frequent and severe symptoms debilitating symptoms. Reported symptoms include pelvic pain, bladder issues, and heavy and/or abnormal menstrual bleeding. For Black women in perimenopause or menopause, uterine fibroids are more likely to continue growing rather than slow or cease. To design empirical research that addresses the issue of uterine fibroids among Black people of African descent, it is important to understand the current state of literature on this issue. The objectives of this scoping review are to understand and describe the extent and type of literature available regarding Black people of African descent with uterine fibroids globally, to identify the gaps within existing literature, and to provide recommendations for future research. This scoping review will be conducted in accordance with JBI scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. Eligibility criteria for this review include sources that involve Black people of African descent who have uterine fibroids. This review is global in context and does not include jurisdictional, geographical, regional or study setting restrictions. A comprehensive search strategy developed in collaboration with a health sciences librarian will be used to identify and retrieve relevant peer-reviewed and grey literature. Databases including CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), Gender Studies Database (EBSCO), Scopus (Elsevier) and LILACS (VHL) will be searched from inception to January 2024. Unpublished studies and grey literature searches will include The Society for Women's Health Research, Black Women's Health Imperative, ProQuest Dissertations and Theses Global (ProQuest), Open Access Theses and Dissertations (OATD.org) and Google search. All relevant sources will be uploaded to Covidence and undergo title and abstract screening by two independent team members. Selected sources will then undergo full-text review by two independent team members. Sources meeting the eligibility criteria will undergo extraction by two independent team members. Thematic analysis will be used to classify the extracted data points into categories according to the purpose or objective of the source, the methods used, the geographical region or jurisdiction of the source, key findings and recommendations. The synthesis of results will align with the review objective and question using charts or tables where necessary. This scoping review does not require ethical approval. Dissemination of the review results includes the publication of a full report in a peer-reviewed journal as well as presenting the review results at local, national and international conferences. The results of the scoping review will also be disseminated through community events and social media using infographics and brochures.

Exploring the Efficacy of Homeopathic Medicines in Treating Uterine Fibroids: A Comprehensive Review

Abstract: Introduction: Uterine fibroids are a common gynaecological condition affecting women worldwide, often leading to significant morbidity and impacting quality of life. While conventional treatment options exist, there is growing interest in alternative therapies such as homeopathy. Objective: The objective of this review paper is to assess the effectiveness of homeopathic medicines in treating uterine fibroids through the analysis of recent clinical trials and observational studies, aiming to provide insights into the potential role of homeopathy as a complementary or alternative therapy for uterine fibroids. Methodology: A thorough search of databases such as PubMed, Google Scholar, Scopus, and pertinent medical journals was undertaken to locate recent studies on the efficacy of homeopathic medicines for uterine fibroids. Only studies meeting predefined inclusion criteria, including randomized controlled trials, prospective observational studies, and systematic reviews, were included in the review process. Result: Recent studies investigating the efficacy of homeopathic medicines in treating uterine fibroids consistently demonstrated positive outcomes, including symptom alleviation, reduction in fibroid size, and improved quality of life. Various remedies showed effectiveness across various potencies. Symptom severity scales, including the Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), and Verbal Multidimensional Scoring System (VMSS), were utilized to assess pelvic pain, menstrual bleeding, and discomfort. Quality of life measures like the WHOQOL-BREF scale provided insights into overall well-being. Conclusion: In conclusion, homeopathic medicines show promise as a safe and effective treatment option for uterine fibroids, offering personalized care and improving quality of life. However, more research, including larger trials and long-term studies, is needed to confirm these findings and understand the underlying mechanisms better.