Treatment Guideline Chart

Leiomyomas or uterine fibroids are benign tumors of the uterus that consist of smooth muscle and extracellular matrix collagen and elastin.

Most common solid pelvic tumors and one of the most frequent clinical conditions encountered in gynecologic practice.

They tend to grow during the reproductive years and usually regress during menopause.


Leiomyomas References

  1. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol. 2008 Aug;112:387-400. http://www.ncbi.nlm.nih.gov/pubmed. PMID: 18669742
  2. Bukulmez O, Doody K. Clinical features of myomas. Obstet Gynecol Clin North Am. 2006 Mar;33(1):69-84. PMID: 16504807
  3. Bradley LD. Uterine fibroid embolization: a viable alternative to hysterectomy. Am J Obstet Gynecol. 2009 Aug;201(2):127-135. doi: 10.1016/j.ajog.2009.01.031. PMID: 19646564
  4. Divakar H. Asymptomatic uterine fibriods. Best Pract Res Clin Obstet Gynecol. 2008 Aug;22(4):643-654. doi: 10.1016/j.bpobgyn.2008.01.007. PMID: 18375184
  5. Evans P, Brunsell S. Uterine fibriod tumors: diagnosis and treatment. Am Fam Physician. 2007 May;75(10):1503-1508. PMID: 17555142
  6. Cheng MH, Chao HT, Wang PH. Medical treatment of uterine myomas. Taiwan J Obstet Gynecol. 2008 Mar;47(1):18-23. doi: 10.1016/S1028-4559(08)60050-9. PMID: 18400578
  7. Luciano AA. Myomectomy. Clin Obstet Gynecol. 2009 Sep;52(3):362-371. doi: 10.1097/GRF.0b013e3181b0bdcd. PMID: 19661752
  8. Istre O. Management of symptomatic fibroids: conservative surgical treatment modalities other than abdominal or laparoscopic myomectomy. Best Pract Res Clin Obstet Gynecol. 2008 Aug;22(4):735-747. doi: 10.1016/j.bpobgyn.2008.01.010. PMID: 18328788
  9. Lefebvre G, Vilos G, Allaire C, et al; Clinical Practice Gynaecology Committee; Society of Obstetricians and Gynaecologists of Canada. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2003 May;25(5):396-418. http://www.ncbi.nlm.nih.gov/pubmed. PMID: 12738981
  10. Marret H, Fritel X, Ouldamer L, et al. Therapeutic management of uterine fibroid tumors: updated French guidelines. Eur J Obstet Gynecol Reprod Biol. 2012 Dec;165(2):156-164. doi: 10.1016/j.ejogrb.2012.07.030. PMID: 22939241
  11. New Zealand Guideline Group. An evidence-based guideline for the management of uterine fibriods. Aust N Z Obstet Gynaecol. 2001;41(2):125-140. PMID: 11453261
  12. Parker WH. Uterine myomas: management. Fertil Steril. 2007 Aug;88(2):255-271. PMID: 17658523
  13. Rackow BW, Arici A. Options for medical treatments of myomas. Obstet Gynecol Clin North Am. 2006 Mar;33(1):97-113. PMID: 16504809
  14. Society of Obstetricians and Gynaecologists of Canada. SOGC clinical practice guidelines. Uterine fibroid embolization (UFE). Number 150, October 2004. Int J Gynecol Obstet. 2005 Jun;89(3):305-318. http://www.ncbi.nlm.nih.gov/pubmed. PMID: 16001461
  15. Reynolds A. Diagnosis and management of uterine fibroids. Radiol Technol. 2007;79(2):157-178. PMID: 18032751
  16. Sankaran S, Manyonda IT. Medical management of fibroids. May 12, 2008. Best Pract Res Clin Obstet Gynaecol. 2008 Aug;22(4):655-676. http://www.ncbi.nlm.nih.gov/pubmed. PMID: 18468953
  17. Wang PH, Lee WL, Cheng MH, et al. Use of gonadotropin-releasing hormone agonists to manage perimenopausal women with symptomatic uterine myomas. Taiwan J Obstet Gynecol. 2009 Jun;48(2):133-137. doi: 10.1016/S1028-4559(09)60273-4. PMID: 19574174
  18. Mishell D, Stenchever M, Droegemuller W, Herbst A. Benign gynecologic lesions. In: Stenchever M. Comprehensive Gynecology. 4th ed. St. Louis: Mosby; 2001
  19. Katz VL, Dotter D. Breast diseases: diagnosis and treatment of benign and malignant disease. In: Katz VL, Lentz GM, Lobo RA, Gerhenson DM. Comprehensive Gynecology. 6th. Philadelphia: Mosby, Elsevier; 2012.
  20. Lethaby A, Vollenhoven B, Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids (Cochrane Review). The Cochcrane Library, Issue 2. Chichester, UK: John Wiley and Sons, Ltd; 2004.
  21. Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics normal and problem pregnancies. 6th. Philadelphia: Saunders, Elsevier; 2012.
  22. Berek JS, Adashi EY, Hillard PA. Novak's gynecology. 12th. Baltimore, MD: Lippincott Williams & Wilkins; 1996.
  23. MedWormhttp://www.medworm.com/rss/index.php/OBGYN/29/http://www.medworm.com/rss/medicalfeeds/specialities/OBGYN.xml
  24. Kristanto H, Karkata MA. Panduan Pentalaksanaan Kasus Obstetri. Himpunan Kedokteran Fetomaternal (HKFM) Perkumpulan Obstetri Ginekologi Indonesia (POGI). 2012.
  25. Agency for Healthcare Research and Quality. Management of uterine fibroids. Evidence report/technology assessment: number 34. http://www.ahcpr.gov. Jan 2001.
  26. Ciarmela P, Ciavattini A, Giannubilo SR, et al. Management of leiomyomas in perimenopausal women. Maturitas. 2014 Jul;78(3):168-173. doi: 10.1016/j.maturitas.2014.04.011. Accessed 05 Jun 2014. PMID: 24835002
  27. Islam MS, Protic O, Giannubilo SR, et al. Uterine leiomyoma: available medical treatments and new possible therapeutic options. J Clin Endocrinol Metab. 2013 Mar;98(3):921-934. doi: 10.1210/jc.2012-3237. Accessed 09 Dec 2014. PMID: 23393173
  28. Vilos G, Allaire C, Laberge PY, et al; Society of Obstetricians and Gynaecologists of Canada. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015;37(2):157-178. http://sogc.org.
  29. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE. https://www.nice.org.uk. Aug 2016. Accessed 18 Oct 2016.
  30. De La Cruz MS, Buchanan EM. Uterine fibroids: diagnosis and treatment. Am Fam Physician. 2017 Jan 15;95(2):100-107. https://www.clinicalkey.com. Accessed 23 Jan 2017. PMID: 28084714
  31. Silberzweig JE, Powell DK, Matsumoto AH, Spies JB. Management of uterine fibroids: a focus on uterine-sparing interventional techniques. Radiology. 2016 Sep;280(3):675-692. doi: 10.1148/radiol.2016141693. PMID: 27533290
  32. Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of uterine myomas: a review. Int J Fertil Steril. 2016 Jan-Mar;9(4):424-435. https://www.ncbi.nlm.nih.gov. Accessed 23 Jan 2017. PMID: 26985330
  33. Donnez J, Dolmans MM. Uterine fibroid management: from the present to the future. Hum Reprod Update. 2016 Nov;22(6):665-686. doi: 10.1093/humupd/dmw023. PMID: 27466209
  34. Farris M, Bastianelli C, Rosato E, et al. Uterine fibroids: an update on current and emerging medical treatment options. Ther Clin Risk Manag. 2019;15:157-178. doi: 10.2147/TCRM.S147318. PMID: 30774352
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