Audit of the uterine leiomyoma

Abstract EN

Background : Leiomyoma, the most common tumor of the female genital tract, is a frequently encountered problem in gynecological practice.

This study was carried out to examine the frequency of leiomyoma's in relation to age, parity and clinical manifestations.

Also, it took an aim at critical review of the management of these lesions.

Patients and Methods : this investigation was carried out over a period of four years (May 2004-May 2007 at Department of Obstetrics and Gynecology, AL-Zahraa Hospitals, AL-Jedanni Hospitals, Ibn-Sina National College of Medicine, Jeddah, (KSA).

All patients presenting with fibroid uterus were included in this study.

Data collection included age, parity, menstrual pattern, clinical symptoms and signs as well as history of both medical and surgical treatment received.

Diagnostic criteria included both clinical features and ultrasonography findings.

Evaluation of medical treatment and surgery were carried out.

Management outcome of minimal invasive surgery was also observed.

Results: A total of 102 cases of uterine leiomyoma were observed (2004-2007).

A higher frequency (65.7 %) was found in females in their late reproductive and premenopausal age groups as compared to ones in the reproductive age period (34.2 %).

The tumors were more frequent among multiparous (70 %) than nulliparous (29 %) females.

Infertility was observed in 18 % of cases and most of them were symptomatic (70 %).

Menstrual symptoms were common (86 %), followed by pain (58 %) and abdominal mass (53 %).

Familial factor noticed in 5.4 % of cases.

Diagnosis was established on clinical and radiological grounds in 83.3 % and 57.7 % of cases, respectively.

Leiomyoma's were multiple in 61.76 % of cases and the interstitial type was the commonest type (58.82 %).

On histology, hyaline degeneration was seen in 45 % of cases.

Conservative treatment was given in 41.18% of cases including medical therapy (14.71 %).

Surgery was performed in 58.82 % of cases (myomectomy and hysterectomy 24.51 % and 34.31 % of cases, respectively.

Minimal invasive surgery was not possible in our set up.

Conclusions : Leiomyoma's are frequent in late reproductive and premenopausal years.

Ultrasonography is most simple and effective diagnostic tool.

Expectant treatment is only helpful in asymptomatic mommas.

In contrast, myomectomy seems to be effective surgical procedures in the management of these tumors.