Skip to main content

Advertisement

SpringerLink
Log in

An Overview of the Aetiology, Epidemiology, Symptomatology and Management of Uterine Fibroids

  • Uterine Fibroids (N Narvekar, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Uterine fibroids are the most common benign tumour to affect women and although many are asymptomatic, those that do cause symptoms often do so with significant morbidity. Whilst historically the mainstay of treatment was abdominal hysterectomy, evolving medical and surgical techniques have facilitated new and often more conservative management options. For those wishing to avoid operative intervention, there are now several medical therapies effective in alleviating the symptoms of fibroids, in some cases reducing their size. Improved access to laparoscopic surgery, along with advances in radiological intervention, have helped to reduce the morbidity of open surgical intervention, providing women with minimally invasive and in some cases, fertility sparing treatment. This review aims to summarise the current understanding of fibroids, as well as exploring the up to date management options and their recent controversies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril [Internet]. 1981 Oct [cited 2015 Nov 23];36(4):433–45. Available from, http://www.ncbi.nlm.nih.gov/pubmed/7026295.

  2. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol [Internet]. 2003 Jan [cited 2015 Oct 1];188(1):100–7. Available from, http://www.ncbi.nlm.nih.gov/pubmed/12548202.

  3. Munro MG, Critchley HOD, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet [Internet]. Elsevier; 2011 Apr 4 [cited 2015 Dec 26];113(1):3–13. Available from: http://www.ijgo.org/article/S0020729211000129/fulltext.

  4. Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22(4):571–88.

    Article  PubMed  Google Scholar 

  5. Mashal RD, Fejzo MLS, Friedman AJ, Mitchner N, Nowak RA, Rein MS, et al. Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata. Genes, Chromosom Cancer [Internet]. Wiley Subscription Services, Inc., A Wiley Company; 1994 Sep 1;11(1):1–6. Available from: 10.1002/gcc.2870110102.

  6. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725–36.

    Article  PubMed  Google Scholar 

  7. Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect [Internet]. 2003 Jun [cited 2016 Jan 10];111(8):1037–54. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1241553&tool=pmcentrez&rendertype=abstract.

  8. Faerstein E, Szklo M, Rosenshein NB. Risk factors for uterine leiomyoma: a practice-based case-controls study. II. Atherogenic risk factors and potential sources of uterine irritation. Am J Epidemiol. 2001;153(1):11–9.

    Article  CAS  PubMed  Google Scholar 

  9. Parazzini F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Epidemiologic characteristics of women with uterine fibroids: a case-control study. Obstet Gynecol [Internet]. 1988;72(6):853–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3186092.

  10. Chen C-R. Risk Factors for Uterine Fibroids among Women Undergoing Tubal Sterilization. Am J Epidemiol [Internet]. 2001 Jan 1 [cited 2016 Jan 9];153(1):20–6. Available from: http://aje.oxfordjournals.org/cgi/content/long/153/1/20.

  11. Wise LA. Reproductive Factors, Hormonal Contraception, and Risk of Uterine Leiomyomata in African-American Women: A Prospective Study. Am J Epidemiol [Internet]. 2004 Jan 15 [cited 2016 Jan 9];159(2):113–23. Available from: http://aje.oxfordjournals.org/cgi/content/long/159/2/113.

  12. Chiaffarino F, Parazzini F, La Vecchia C, Marsico S, Surace M, Ricci E. Use of oral contraceptives and uterine fibroids: results from a case-control study. Br J Obstet Gynaecol [Internet]. 1999 Aug [cited 2016 Jan 9];106(8):857–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10453838.

  13. Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine fibroids: reduced risk associated with oral contraceptives. Br Med J (Clin Res Ed) [Internet]. 1986;293(6543):359–62. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1341047&tool=pmcentrez&rendertype=abstract.

  14. Lumbiganon P, Rugpao S, Phandhu-fung S, Laopaiboon M, Vudhikamraksa N, Werawatakul Y. Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case--control study. Br J Obstet Gynaecol [Internet]. 1996 Sep [cited 2016 Jan 9];103(9):909–14. Available from, http://www.ncbi.nlm.nih.gov/pubmed/8813312.

  15. Magalhães J, Aldrighi JM, de Lima GR. Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas. Contraception. 2007;75:193–8.

    Article  PubMed  Google Scholar 

  16. Okolo SO, Gentry CC, Perrett CW, Maclean AB. Familial prevalence of uterine fibroids is associated with distinct clinical and molecular features. Hum Reprod [Internet]. 2005;20(8):2321–4. Available from: http://humrep.oxfordjournals.org/content/20/8/2321.full.

  17. Treloar SA, Martin NG, Dennerstein L, Raphael B, Heath AC. Pathways to hysterectomy: insights from longitudinal twin research. Am J Obstet Gynecol. 1992;167(1):82–8.

    Article  CAS  PubMed  Google Scholar 

  18. Farrer-Brown G, Beilby JOW, Tarbit MH. THE VASCULAR PATTERNS IN MYOMATOUS UTERI. BJOG An Int J Obstet Gynaecol [Internet]. 1970 Nov [cited 2016 Jan 10];77(11):967–75. Available from: http://doi.wiley.com/10.1111/j.1471-0528.1970.tb03439.x.

  19. Stewart EA. Uterine fibroids. Lancet (London, England) [Internet]. Elsevier; 2001 Jan 27 [cited 2015 Sep 12];357(9252):293–8. Available from: http://www.thelancet.com/article/S0140673600036229/fulltext.

  20. Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril [Internet]. 2009;91(4):1215–23. Available from: http://www.sciencedirect.com/science/article/pii/S0015028208001465.

  21. Cooper NP, Okolo S. Fibroids in pregnancy--common but poorly understood. Obstet Gynecol Surv [Internet]. 2005 Feb [cited 2016 Jan 9];60(2):132–8. Available from, http://www.ncbi.nlm.nih.gov/pubmed/15671902.

  22. Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BWJ, D’Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev [Internet]. 2013;1(11):CD009461. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23440838.

  23. Carranza-Mamane B, Havelock J, Hemmings R, Cheung A, Sierra S, Carranza-Mamane B, et al. The management of uterine fibroids in women with otherwise unexplained infertility. J Obstet Gynaecol Can. 2015;37(3):277–88.

    Article  PubMed  Google Scholar 

  24. Metwally M, Cheong YC, Horne AW. Surgical treatment of fibroids for subfertility. Cochrane database Syst Rev [Internet]. 2012 Jan [cited 2016 Jan 10];11:CD003857. Available from: http://www.cochrane.org/CD003857/MENSTR_surgical-removal-of-fibroids-does-not-improve-fertility-outcomes.

  25. Lev-Toaff a S, Coleman BG, Arger PH, Mintz MC, Arenson RL, Toaff ME. Leiomyomas in pregnancy: sonographic study. Radiology [Internet]. 1987;164(2):375–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3299488.

  26. Lumsden MA, Hamoodi I, Gupta J, Hickey M. Fibroids: diagnosis and management. Bmj [Internet]. 2015;4887(October):h4887. Available from: http://www.bmj.com/lookup/doi/10.1136/bmj.h4887. Recent review article summarising current practice in diagnosis and management of uterine fibroids .

  27. Mercorio F, De Simone R, Di Spiezio Sardo A, Cerrota G, Bifulco G, Vanacore F, et al. The effect of a levonorgestrel-releasing intrauterine device in the treatment of myoma-related menorrhagia. Contraception [Internet]. Elsevier; 2003 Apr 4 [cited 2016 Jan 9];67(4):277–80. Available from: http://www.contraceptionjournal.org/article/S001078240200522X/fulltext.

  28. Olive DL, Lindheim SR, Pritts EA. Non-surgical management of leiomyoma: impact on fertility. Curr Opin Obstet Gynecol. 2004;16(January):239–43.

    Article  PubMed  Google Scholar 

  29. Lethaby a, Vollenhoven B, Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2001;(2):CD000547.

  30. Kunde D, Khalaf Y. Alternatives to hysterectomy for treatment of uterine fibroids. Obstet Gynaecol [Internet]. 2004;6(4):215–21. Available from: http://doi.wiley.com/10.1576/toag.6.4.215.27018.

  31. Chabbert-Buffet N, Pintiaux A, Bouchard P. The immninent dawn of SPRMs in obstetrics and gynecology. Mol Cell Endocrinol [Internet]. Elsevier Ireland Ltd; 2012;358(2):232–43. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22415029.

  32. Catherino WH, Malik M, Driggers P, Chappel S, Segars J, Davis J. Novel, orally active selective progesterone receptor modulator CP8947 inhibits leiomyoma cell proliferation without adversely affecting endometrium or myometrium. J Steroid Biochem Mol Biol [Internet]. 2010;122(4):279–86. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20493256.

  33. Esmya® (ulipristal acetate 5mg) Global Portal [Internet]. [cited 2016 Jan 10]. Available from: http://www.esmya.co.uk/references/. Updated UK license for uliprisal acetate.

  34. Donnez J, Hudecek R, Donnez O, Matule D, Arhendt H-J, Zatik J, et al. Efficacy and safety of repeated use of ulipristal acetate in uterine fibroids. Fertil Steril [Internet]. 2015;103(2):519–27.e3. Available from: http://www.sciencedirect.com/science/article/pii/S0015028214022985. Evidence from PEARL IV trial supporting intermittent use of ulipristal acetete for uterine fibroids.

  35. Sawin SW, Pilevsky ND, Berlin JA, Barnhart KT. Comparability of perioperative morbidity between abdominal myomectomy and hysterectomy for women with uterine leiomyomas. Am J Obstet Gynecol [Internet]. 2000 Dec [cited 2015 Dec 1];183(6):1448–55. Available from, http://www.ncbi.nlm.nih.gov/pubmed/11120509.

  36. Mais V, Ajossa S, Guerriero S, Mascia M, Solla E, Melis GB. Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol [Internet]. 1996 Feb [cited 2016 Jan 10];174(2):654–8. Available from, http://www.ncbi.nlm.nih.gov/pubmed/8623802.

  37. Nezhat FR, Roemisch M, Nezhat CH, Seidman DS, Nezhat CR. Recurrence rate after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc [Internet]. 1998 Aug [cited 2016 Jan 10];5(3):237–40. Available from, http://www.ncbi.nlm.nih.gov/pubmed/9668143.

  38. Fauconnier A, Chapron C, Babaki-Fard K, Dubuisson JB. Recurrence of leiomyomata after myomectomy. Hum Reprod Update [Internet]. Jan [cited 2016 Jan 10];6(6):595–602. Available from, http://www.ncbi.nlm.nih.gov/pubmed/11129693.

  39. Pelosi MA. Spontaneous uterine rupture at thirty-three weeks subsequent to previous superficial laparoscopic myomectomy. Am J Obstet Gynecol [Internet]. 1997 Dec [cited 2016 Jan 10];177(6):1547–9. Available from, http://www.ncbi.nlm.nih.gov/pubmed/9423770.

  40. Gyamfi-bannerman C, Gilbert S, Landon MB, Catherine Y, Rouse DJ, Varner MW, et al. Risk of uterine rupture and placenta accreta with prior uterine surgery outside of the lower segment. Obstet Gynecol. 2012;120(6):1332–7.

    PubMed  PubMed Central  Google Scholar 

  41. Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, et al. Arterial embolisation to treat uterine myomata. Lancet. 1995;346(8976):671–2.

    Article  CAS  PubMed  Google Scholar 

  42. Moss JG, Cooper KG, Khaund A, Murray LS, Murray GD, Wu O, et al. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG [Internet]. 2011;118(8):936–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21481151. Comparison of longterm outcome following UAE or surgical management of uterine fibroids.

  43. Spies JB, Myers ER, Worthington-Kirsch R, Mulgund J, Goodwin S, Mauro M. The FIBROID Registry: symptom and quality-of-life status 1 year after therapy. Obstet Gynecol [Internet]. 2005 Dec [cited 2016 Jan 9];106(6):1309–18. Available from, http://www.ncbi.nlm.nih.gov/pubmed/16319257.

  44. Clinical recommendations on the use of uterine artery embolisation (UAE) in the management of fibroids. R Coll Radiol. 2013. Recommendations for use of uterine artery embolisation in treatment of uterine fibroids.

  45. Edwards RD, Moss JG, Lumsden MA, Wu O, Murray LS, Twaddle S, et al. Uterine-Artery Embolization versus Surgery for Symptomatic Uterine Fibroids. N Engl J Med [Internet]. 2007 Jan 25 [cited 2016 Jan 10];356(4):360–70. Available from, http://www.ncbi.nlm.nih.gov/pubmed/17251532.

  46. Van Der Kooij SM, Hehenkamp WJK, Volkers NA., Birnie E, Ankum WM, Reekers JA. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-Year outcome from the randomized EMMY trial. Am J Obstet Gynecol [Internet]. 2010;203(2):105.e1–105.e13. Available from: http://dx.doi.org/10.1016/j.ajog.2010.01.049.

  47. Manyonda IT, Bratby M, Horst JS, Banu N, Gorti M, Belli A-M. Uterine artery embolization versus myomectomy: impact on quality of life--results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial. Cardiovasc Intervent Radiol [Internet]. 2012;35(3):530–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21773858.

  48. Homer H, Saridogan E. Uterine artery embolization for fibroids is associated with an increased risk of miscarriage. Fertil Steril [Internet]. Elsevier Ltd; 2010;94(1):324–30. Available from: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=19361799&retmode=ref&cmd=prlinks\npapers2://publication/doi/10.1016/j.fertnstert.2009.02.069.

  49. Wood RW, Loomis AL. The physical and biological effects of high-frequency sound-waves of great intensity. Philos Mag Ser 7 [Internet]. 1927;4(22):417–36. Available from: http://www.tandfonline.com/doi/abs/10.1080/14786440908564348.

  50. Lynn JG, Zwemer RL, Chick AJ, Miller AE. A NEW METHOD FOR THE GENERATION AND USE OF FOCUSED ULTRASOUND IN EXPERIMENTAL BIOLOGY. J Gen Physiol [Internet]. 1942 Nov 20 [cited 2016 Jan 10];26(2):179–93. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2142058&tool=pmcentrez&rendertype=abstract.

  51. Magnetic Resonance-guided Focused Ultrasound for Uterine Fibroids | GLOWM [Internet]. [cited 2016 Jan 10]. Available from: http://www.glowm.com/section_view/heading/Magnetic Resonance-guided Focused Ultrasound for Uterine Fibroids/item/531.

  52. Funaki K, Fukunishi H, Funaki T, Sawada K, Kaji Y, Maruo T. Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images. Am J Obstet Gynecol [Internet]. 2007 Feb [cited 2016 Jan 9];196(2):184.e1–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17306674.

  53. Ananthakrishnan G, Murray L, Ritchie M, Murray G, Bryden F, Lassman S, et al. Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): subanalysis of 5-year MRI findings. Cardiovasc Intervent Radiol [Internet]. 2013 Jun [cited 2015 Dec 18];36(3):676–81. Available from, http://www.ncbi.nlm.nih.gov/pubmed/23070101.

  54. Clark NA, Mumford SL, Segars JH. Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence. Curr Opin Obstet Gynecol [Internet]. 2014;26(3):151–61. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4137489&tool=pmcentrez&rendertype=abstract. Evidence to support MRI guided focused surgery in women wishing to retain fertility.

  55. FDA Approves INSIGHTEC’s Next Generation Exablate Fibroid Treatment System and Removes Requirement… -- HAIFA, Israel, October 7, 2015 /PRNewswire/ -- [Internet]. [cited 2016 Jan 10]. Available from: http://www.prnewswire.com/news-releases/fda-approves-insightecs-next-generation-exablate-fibroid-treatment-system-and-removes-requirement-for-patients-to-be-family-complete-531046341.html.

  56. Bouwsma EVA, Gorny KR, Hesley GK, Jensen JR, Peterson LG, Stewart EA. Magnetic resonance-guided focused ultrasound surgery for leiomyoma-associated infertility. Fertil Steril [Internet]. 2011 Jul [cited 2016 Jan 9];96(1):e9–12. Available from, http://www.ncbi.nlm.nih.gov/pubmed/21570071.

  57. Qin J, Chen JY, Zhao WP, Hu L, Chen WZ, Wang ZB. Outcome of unintended pregnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids. Int J Gynecol Obstet [Internet]. 2012;117(3):273–7. Available from: http://dx.doi.org/10.1016/j.ijgo.2012.01.011.

  58. Sarah L. Cohen MM. Power morcellation for uterine fibroids: What you need to know. Advanstar Communications Inc; 2014 Mar 1 [cited 2016 Jan 10]; Available from: http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/power-morcellation-uterine-fibroids-what-you-need-know?page=full.

  59. Steiner RA, Wight E, Tadir Y, Haller U. Electrical cutting device for laparoscopic removal of tissue from the abdominal cavity. Obstet Gynecol [Internet]. 1993;81(3):471–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8437807.

  60. Knight J, Falcone T. Tissue extraction by morcellation: a clinical dilemma. J Minim Invasive Gynecol [Internet]. Elsevier; 2014 Jan 5 [cited 2016 Jan 9];21(3):319–20. Available from: http://www.jmig.org/article/S155346501400199X/fulltext. Overview of the potential problems associated with tissue morcellation.

  61. Kho KA, Nezhat CH. Evaluating the risks of electric uterine morcellation. JAMA [Internet]. 2014 Mar 5 [cited 2016 Jan 9];311(9):905–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24504415. Overview of potential risk of uterine power morcellation.

  62. Leung F, Terzibachian J-J. Re: “The impact of tumor morcellation during surgery on the prognosis of patients with apparently early uterine leiomyosarcoma.” Gynecol Oncol [Internet]. Elsevier; 2012 Jan 1 [cited 2016 Jan 9];124(1):172–3. Available from: http://www.gynecologiconcology-online.net/article/S0090825811007207/fulltext. Discussion of risk of potentially disseminating occult malignancy.

  63. Senapati S, Tu FF, Magrina JF. Power morcellators: a review of current practice and assessment of risk. Am J Obstet Gynecol [Internet]. 2015;212(1):18–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25072737. Recent update and review of the potential complications of uterine power morcellation and advise for patient selection.

  64. Milad MP, Milad E a. Laparoscopic morcellator-related complications. J Minim Invasive Gynecol [Internet]. 2014;21(3):486–91. Available from: http://dx.doi.org/10.1016/j.jmig.2013.12.003.

  65. Health C for D and R. Safety Communications - Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication [Internet]. Center for Devices and Radiological Health; [cited 2016 Jan 10]. Available from: http://www.fda.gov/medicaldevices/safety/alertsandnotices/ucm393576.htm . Initial FDA communication on the use of uterine power mocellation.

  66. Health C for D and R. Safety Communications - UPDATED Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication [Internet]. Center for Devices and Radiological Health; [cited 2016 Feb 24]. Available from: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm. Updated FDA communication on the use of uterine tissue morcellation.

  67. Brölmann H, Tanos V, Grimbizis G, Ind T, Philips K, van den Bosch T, et al. Options on fibroid morcellation: a literature review. Gynecol Surg [Internet]. 2015;12(1):3–15. Available from: http://link.springer.com/10.1007/s10397-015-0878-4

  68. Pritts EA, Vanness DJ, Berek JS, Parker W, Feinberg R, Feinberg J, et al. The prevalence of occult leiomyosarcoma at surgery for presumed uterine fibroids: a meta-analysis. Gynecol Surg [Internet]. Jan [cited 2016 Jan 10];12(3):165–77. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4532723&tool=pmcentrez&rendertype=abstract. Evidence to suggest potential overestimation of prevelence of occult leiomyosarcoma.

  69. Aviram R, Ochshorn Y, Markovitch O, Fishman A, Cohen I, Altaras MM, et al. Uterine sarcomas versus leiomyomas: gray-scale and Doppler sonographic findings. J Clin Ultrasound [Internet]. 2005;33(1):10–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15690441.

  70. Fukunishi H, Funaki K, Ikuma K, Kaji Y, Sugimura K, Kitazawa R, et al. Unsuspected uterine leiomyosarcoma: magnetic resonance imaging findings before and after focused ultrasound surgery. Int J Gynecol Cancer [Internet]. Jan [cited 2016 Jan 9];17(3):724–8. Available from, http://www.ncbi.nlm.nih.gov/pubmed/17300682.

  71. Parker WH, Fu YS, Berek JS. Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol [Internet]. 1994 Mar [cited 2016 Jan 9];83(3):414–8. Available from, http://www.ncbi.nlm.nih.gov/pubmed/8127535.

  72. Kawamura N, Iwanaga N, Hada S, Maeda K, Sumi T, Ishiko O, et al. Transient shrinkage of a uterine leiomyosarcoma treated with GnRH agonist for a presumed uterine leiomyoma: Comparison of magnetic resonance imaging finding before and during GnRH agonist treatment. Oncol Rep [Internet]. Spandidos Publications; 2001 Nov 1 [cited 2016 Jan 9];8(6):1255–7. Available from: http://www.spandidos-publications.com/or/8/6/1255/abstract.

  73. Einarsson JI, Cohen SL, Fuchs N, Wang KC. In-bag morcellation. J Minim Invasive Gynecol [Internet]. Elsevier; 2014 Jan 9 [cited 2016 Jan 9];21(5):951–3. Available from: http://www.jmig.org/article/S1553465014002568/fulltext. Proposed method for safer uterine power morcellation.

  74. McKenna JB, Kanade T, Choi S, Tsai BP, Rosen DM, Cario GM, et al. The Sydney Contained in Bag Morcellation Technique. J Minim Invasive Gynecol [Internet]. Elsevier; 2014 Nov 11 [cited 2016 Jan 9];21(6):984–5. Available from: http://www.jmig.org/article/S1553465014003513/fulltext.

  75. Hysteroscopic morcellation of uterine leiomyomas (fibroids) | 1-Recommendations | Guidance and guidelines | NICE. NICE; [cited 2016 Feb 24]; Available from: http://www.nice.org.uk/guidance/IPG522/chapter/1-Recommendations . UK guidence for hysteroscopic morcellation.

  76. Uterine sarcoma & power morcellation | Sarcoma UK [Internet]. [cited 2016 Jan 10]. Available from: https://sarcoma.org.uk/news/2014/11/uterine-sarcoma-power-morcellation.

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Borders General Hospital, Melrose, TD6 9BS, UK

    Alexandra Catherine Viner & Maria Queenie Menezes

Authors
  1. Alexandra Catherine Viner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Queenie Menezes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Queenie Menezes.

Ethics declarations

Conflict of Interest

Alexandra Catherine Viner and Maria Queenie Menezes declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Uterine Fibroids

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Viner, A.C., Menezes, M.Q. An Overview of the Aetiology, Epidemiology, Symptomatology and Management of Uterine Fibroids. Curr Obstet Gynecol Rep 5, 65–72 (2016). https://doi.org/10.1007/s13669-016-0150-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13669-016-0150-6

Keywords

Search

Navigation