الأورام الليفية الرحمية مع أعراض ضخامة الحوض أو الضغط: الإدارة الإجرائية والجراحية بعد علاج ناهض أو مضاد GnRH

References

DOI: 10.1016/j.jogc.2025.102970

1. Patients with fibroids and bulk symptoms may be offered gonadotropin-releasing hormone agonists or antagonists.
2. Uterine artery embolization may be offered as a minimally invasive technique that can reduce fibroid symptoms in patients wishing to preserve their uterus.
3. Patients should be aware that uterine artery embolization may be associated with decreased fertility, higher miscarriage rate, and adverse pregnancy outcomes, and is not advised in patients wishing for future fertility.
4. Radiofrequency ablation (RFA) may be offered as an option in the management of symptomatic uterine fibroids with comparable outcomes to myomectomy, with potential for decreased surgical bleeding and faster recovery.
5. High Intensity Focused Ultrasound (HIFU) may be offered as a minimally invasive treatment option for uterine fibroids, but it is not widely available in Canada.
6. In symptomatic patients wishing to preserve their fertility and/or their uterus, myomectomy may be offered.
7. Definitive treatment for uterine fibroids is hysterectomy.
8. Clinical outcomes following UAE include 50-60% reduction in leiomyoma volume, 40-50% in uterine volume, 88-92% reduction in bulk symptoms, elimination of abnormal uterine bleeding (>90%), successful elimination of symptoms (75%), and high patient satisfaction rates (80-90%).