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Treatment of uterine leiomyomas

Treatment of uterine leiomyomas. Sun Xiantao. Risk factors for myoma development include obesity, early age of first menarche, race, and infertility, Protective factors include smoking exercise, oral contraceptive use, and parity （经产） . Follow.

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Treatment of uterine leiomyomas

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  1. Treatment of uterine leiomyomas Sun Xiantao

  2. Risk factors for myoma development include obesity, early age of first menarche, race, and infertility, • Protective factors include smoking exercise, oral contraceptive use, and parity（经产） .

  3. Follow • Follow when the myomas are small and asymptomatic, especially when the patient is near her menopause.

  4. Indications for medical treatments • Myomas are not large • Symptoms are not apparent • Perimenopause • Cannot stand surgery • Patients desire!!!

  5. Medical managements • Estrogen and progestin therapy • Steroid synthesis inhibitors • GnRHa • GnRH antagonists-ganirelix and cetrorelix • Aromatase inhibitors

  6. Steroid receptor modulators • SERMs——Tamoxifen • SPRMs • Androgen therapy-asoprisnil • Progestin-containing intrauterine contraceptive devices (IUDs)

  7. Surgery indications • More than 10w pregnant uterus • Complicating or inducing anemia • Dysfunction of adjacent organs such as bowel and bladder, and reproductive dysfunction including infertility • To exclude malignancy • Cervical, broad ligament, or submucous

  8. Surgical managements • Myomectomy • Abdominal myomectomy • Laparoscopic myomectomy • Hysteroscopic myomectomy • Myolysis • Uterine artery ligation and occlusion • Hysterectomy • Total • Subtotal

  9. Thank You!

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