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Analyzing leiomyomas with FIGO classification regarding parity, body mass index and admission symptoms

Year 2025, Volume: 8 Issue: 2, 319 - 324, 21.03.2025
https://doi.org/10.32322/jhsm.1596426

Abstract

Aims: To examine the outcomes of leiomyomas classified by FIGO in relation to the demographic, clinical, and laboratory characteristics of patients who underwent laparotomic myomectomy.
Methods: A total of 199 patients were found between September 2019 and September 2023 according to the criteria for study. Data were analyzed and compared in terms of FIGO leiomyoma classification, leiomyoma size, admission symptoms, body-mass index (BMI) and parity. All demographical and operational features were compared in each group for issues including leiomyomas >8 cm, <8 cm; single or multiple leiomyomas; BMI >30, <30; multiparous and nulliparous patients. Moreover, patients’ admission symptoms as abnormal uterine bleeding, pelvic pain and compression were also recorded and compared.
Results: The mean leiomyoma size, compression symptoms and pelvic pain of those with abnormal uterine bleeding was 8.5±3.2 cm, 9.6±3.1 cm, and 10.9±3.6 cm; respectively. The mean leiomyoma size of individuals with pelvic pain was significantly larger than that of those with abnormal uterine bleeding (p<0.05). Nulliparous patients exhibited a higher incidence of multiple myomas than multiparous patients. Nulliparous patients experienced a lower incidence of abnormal uterine hemorrhage than multiparous patients; however, the incidence of pelvic pain and pressure symptoms was more common (p=0.013). The mean leiomyoma size of those with BMI <30 and BMI ≥30 was 9.8±3.6 cm, and 9.2±3.1 cm; respectively. No statistically significant difference was observed between these groups in terms of mean leiomyoma size, operation time, hospital stay and postoperative complications (p>0.05).
Conclusion: When evaluating laparotomic myomectomy patients, the patient’s parity status, location and size of the leiomyoma should be taken into consideration before surgery.

References

  • 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. 2003;188(1):100-107. doi:10. 1067/mob.2003.99
  • Serden SP, Brooks PG. Treatment of abnormal uterine bleeding with the gynecologic resectoscope. J Reprod Med. 1991;36(10):697-699.
  • Ahrendt HJ, Tylkoski H, Rabe T, et al. Prevalence of uterine myomas in women in Germany: data of an epidemiological study. Arch Gynecol Obstet. 2016;293(6):1243-1253. doi:10.1007/s00404-015-3930-8
  • Giuliani E, As-Sanie S, Marsh EE. Epidemiology and management of uterine fibroids. Int J Gynaecol Obstet. Apr 2020;149(1):3-9. doi:10.1002/ijgo.13102
  • Borah BJ, Nicholson WK, Bradley L, Stewart EA. The impact of uterine leiomyomas: a national survey of affected women. Am J Obstet Gynecol. 2013;209(4):319-320. doi:10.1016/j.ajog.2013.07.017
  • Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015; 372(17):1646-1655. doi:10.1056/NEJMcp1411029
  • Munro MG, Critchley HO, Fraser IS, Group FMDW. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95(7):2204-2208. doi:10.1016/j.fertnstert.2011. 03.079
  • Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol. 1993; 82(5):736-740.
  • Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90(6):967-973. doi:10.1016/s0029-7844(97)00534-6
  • Stewart EA, Friedman AJ. Steroidal treatment of myomas: preoperative and long-term medical therapy. Copyright© 1992 by Thieme Medical Publishers, Inc.; 1992:344-357.
  • Sato F, Miyake H, Nishi M, Kudo R. Fertility and uterine size among Asian women undergoing hysterectomy for leiomyomas. Int J Fertil Womens Med. 2000;45(1):34-37.
  • 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). 1986;293(6543):359-362. doi:10. 1136/bmj.293.6543.359
  • Parazzini F, Negri E, La Vecchia C, Chatenoud L, Ricci E, Guarnerio P. Reproductive factors and risk of uterine fibroids. Epidemiology. 1996; 7(4):440-442. doi:10.1097/00001648-199607000-00018
  • Marshall LM, Spiegelman D, Goldman MB, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertil Steril. 1998;70(3):432-439. doi:10.1016/s0015-0282(98)00208-8
  • Wachsberg RH, Kurtz AB, Levine CD, Solomon P, Wapner RJ. Real-time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements. J Ultrasound Med. Mar 1994;13(3):215-221. doi:10.7863/jum.1994.13.3.215
  • Hsu KF, Pan HA, Hsu YY, Wu CM, Chung WJ, Huang SC. Enhanced myometrial autophagy in postpartum uterine involution. Taiwan J Obstet Gynecol. 2014;53(3):293-302. doi:10.1016/j.tjog.2013.01.030
  • Foth D, Röhl FW, Friedrich C, et al. Symptoms of uterine myomas: data of an epidemiological study in Germany. Arch Gynecol Obstet. 2017; 295(2):415-426. doi:10.1007/s00404-016-4239-y
  • Monleón J, Cañete ML, Caballero V, et al. Epidemiology of uterine myomas and clinical practice in Spain: an observational study. Eur J Obstet Gynecol Reprod Biol. 2018;226:59-65. doi:10.1016/j.ejogrb.2018. 05.026
  • Lacey CG. Myoma of the uterus. Current gynecologic and obstetric diagnosis and treatment 4th ed Lange, Los Altos. 1982.
  • Puri K, Famuyide AO, Erwin PJ, Stewart EA, Laughlin-Tommaso SK. Submucosal fibroids and the relation to heavy menstrual bleeding and anemia. Am J Obstet Gynecol. 2014;210(1):38 e1-7. doi:10.1016/j.ajog. 2013.09.038
  • David M, Pitz CM, Mihaylova A, Siedentopf F. Myoma-associated pain frequency and intensity: a retrospective evaluation of 1548 myoma patients. Eur J Obstet Gynecol Reprod Biol. 2016;199:137-140. doi:10.1016/ j.ejogrb.2016.02.026
  • Cinar M, Tokmak A, Guzel AI, et al. Association of clinical outcomes and complications with obesity in patients who have undergone abdominal myomectomy. J Chin Med Assoc. 2016;79(8):435-439. doi:10. 1016/j.jcma.2016.02.008
  • Wen KC, Horng HC, Wang PH. Hemorrhage: A strong indicator for myomectomy-related complication. J Chin Med Assoc. 2016;79(8):413-414. doi:10.1016/j.jcma.2016.02.004
  • Gürbüz T, Yardımcı O, Udum S, Günay T. The relationship between body-mass index and clinical complications among patients undergoing myomectomy. J Surg Med. 2020;4(11):1027-1030.

Parite, vücut kitle indeksi ve yatış semptomları açısından FIGO sınıflandırması ile leiomyomaların analizi

Year 2025, Volume: 8 Issue: 2, 319 - 324, 21.03.2025
https://doi.org/10.32322/jhsm.1596426

Abstract

Amaç: Çalışmamızın amacı, laparotomik miyomektomi geçiren hastaların demografik, klinik ve laboratuvar özelliklerini ve FIGO tarafından sınıflandırılan leiomyomaların sonuçlarını incelemekti.
Gereç ve yöntemler: Eylül 2019 ile Eylül 2023 arasında çalışma kriterlerine göre toplam 199 hasta bulundu. Veriler FIGO leiomyoma sınıflandırması, leiomyoma boyutu, yatış semptomları, vücut kitle indeksi (VKİ), parite açısından analiz edildi ve karşılaştırıldı. Her grupta tüm demografik ve operasyonel özellikler, leiomyomalar > 8 cm, < 8 cm; tek veya çoklu leiomyomalar; VKİ > 30, < 30; multipar ve nullipar hastalar dahil olmak üzere sonuçlar açısından karşılaştırıldı. Ayrıca, anormal uterin kanama, pelvik ağrı ve bası gibi yatış semptomları da kaydedildi ve karşılaştırıldı.
Sonuçlar: Pelvik ağrısı olan hastalarda ortalama leiomyoma boyutunun anormal uterin kanaması olanlara göre daha büyük olduğu bulundu. Nullipar hastalarda, multipar hastalara göre daha yüksek oranda multipl miyom görüldüğü bulundu. Nullipar hastalarda, multipar hastalara göre anormal uterin kanama insidansı daha düşük bulundu; ancak, pelvik ağrı ve bası semptomlarının insidansı artmıştı.. BMI <30 olanların ortalama leiomyoma boyutu 9,8±3,6 cm, BMI ≥30 olanların ortalama leiomyoma boyutu ise 9,2±3,1 cm bulundu. Gruplar arasında ortalama leiomyoma boyutu, operasyon süresi, hastanede kalış süresi ve postoperatif komplikasyonlar açısından istatistiksel olarak anlamlı bir fark gözlenmedi
Sonuçlar: Laparotomik miyomektomi hastaları değerlendirilirken, hastanın parite durumu, leiomyomanın yeri ve boyutu ameliyattan önce dikkate alınmalıdır.

References

  • 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. 2003;188(1):100-107. doi:10. 1067/mob.2003.99
  • Serden SP, Brooks PG. Treatment of abnormal uterine bleeding with the gynecologic resectoscope. J Reprod Med. 1991;36(10):697-699.
  • Ahrendt HJ, Tylkoski H, Rabe T, et al. Prevalence of uterine myomas in women in Germany: data of an epidemiological study. Arch Gynecol Obstet. 2016;293(6):1243-1253. doi:10.1007/s00404-015-3930-8
  • Giuliani E, As-Sanie S, Marsh EE. Epidemiology and management of uterine fibroids. Int J Gynaecol Obstet. Apr 2020;149(1):3-9. doi:10.1002/ijgo.13102
  • Borah BJ, Nicholson WK, Bradley L, Stewart EA. The impact of uterine leiomyomas: a national survey of affected women. Am J Obstet Gynecol. 2013;209(4):319-320. doi:10.1016/j.ajog.2013.07.017
  • Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015; 372(17):1646-1655. doi:10.1056/NEJMcp1411029
  • Munro MG, Critchley HO, Fraser IS, Group FMDW. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95(7):2204-2208. doi:10.1016/j.fertnstert.2011. 03.079
  • Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol. 1993; 82(5):736-740.
  • Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90(6):967-973. doi:10.1016/s0029-7844(97)00534-6
  • Stewart EA, Friedman AJ. Steroidal treatment of myomas: preoperative and long-term medical therapy. Copyright© 1992 by Thieme Medical Publishers, Inc.; 1992:344-357.
  • Sato F, Miyake H, Nishi M, Kudo R. Fertility and uterine size among Asian women undergoing hysterectomy for leiomyomas. Int J Fertil Womens Med. 2000;45(1):34-37.
  • 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). 1986;293(6543):359-362. doi:10. 1136/bmj.293.6543.359
  • Parazzini F, Negri E, La Vecchia C, Chatenoud L, Ricci E, Guarnerio P. Reproductive factors and risk of uterine fibroids. Epidemiology. 1996; 7(4):440-442. doi:10.1097/00001648-199607000-00018
  • Marshall LM, Spiegelman D, Goldman MB, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertil Steril. 1998;70(3):432-439. doi:10.1016/s0015-0282(98)00208-8
  • Wachsberg RH, Kurtz AB, Levine CD, Solomon P, Wapner RJ. Real-time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements. J Ultrasound Med. Mar 1994;13(3):215-221. doi:10.7863/jum.1994.13.3.215
  • Hsu KF, Pan HA, Hsu YY, Wu CM, Chung WJ, Huang SC. Enhanced myometrial autophagy in postpartum uterine involution. Taiwan J Obstet Gynecol. 2014;53(3):293-302. doi:10.1016/j.tjog.2013.01.030
  • Foth D, Röhl FW, Friedrich C, et al. Symptoms of uterine myomas: data of an epidemiological study in Germany. Arch Gynecol Obstet. 2017; 295(2):415-426. doi:10.1007/s00404-016-4239-y
  • Monleón J, Cañete ML, Caballero V, et al. Epidemiology of uterine myomas and clinical practice in Spain: an observational study. Eur J Obstet Gynecol Reprod Biol. 2018;226:59-65. doi:10.1016/j.ejogrb.2018. 05.026
  • Lacey CG. Myoma of the uterus. Current gynecologic and obstetric diagnosis and treatment 4th ed Lange, Los Altos. 1982.
  • Puri K, Famuyide AO, Erwin PJ, Stewart EA, Laughlin-Tommaso SK. Submucosal fibroids and the relation to heavy menstrual bleeding and anemia. Am J Obstet Gynecol. 2014;210(1):38 e1-7. doi:10.1016/j.ajog. 2013.09.038
  • David M, Pitz CM, Mihaylova A, Siedentopf F. Myoma-associated pain frequency and intensity: a retrospective evaluation of 1548 myoma patients. Eur J Obstet Gynecol Reprod Biol. 2016;199:137-140. doi:10.1016/ j.ejogrb.2016.02.026
  • Cinar M, Tokmak A, Guzel AI, et al. Association of clinical outcomes and complications with obesity in patients who have undergone abdominal myomectomy. J Chin Med Assoc. 2016;79(8):435-439. doi:10. 1016/j.jcma.2016.02.008
  • Wen KC, Horng HC, Wang PH. Hemorrhage: A strong indicator for myomectomy-related complication. J Chin Med Assoc. 2016;79(8):413-414. doi:10.1016/j.jcma.2016.02.004
  • Gürbüz T, Yardımcı O, Udum S, Günay T. The relationship between body-mass index and clinical complications among patients undergoing myomectomy. J Surg Med. 2020;4(11):1027-1030.
There are 24 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Article
Authors

Gurbet Yağmacı 0000-0002-5892-5589

Fikriye Işıl Adıgüzel 0000-0001-6849-2193

Gülsüm Uysal 0000-0002-9381-4892

Publication Date March 21, 2025
Submission Date December 5, 2024
Acceptance Date March 3, 2025
Published in Issue Year 2025 Volume: 8 Issue: 2

Cite

AMA Yağmacı G, Adıgüzel FI, Uysal G. Analyzing leiomyomas with FIGO classification regarding parity, body mass index and admission symptoms. J Health Sci Med / JHSM. March 2025;8(2):319-324. doi:10.32322/jhsm.1596426

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