In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform.?...In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform.?Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.?Patients and Method:?It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.?Results: We collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e.?a frequency of 51.92%.?Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%).?The surgical treatment was conservative in 92.60%. The total hysterectomy performed in 7.40.?Lethality was 1.4%.?Conclusion: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In our context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment is necessary for less invasive surgery.展开更多
Objective： To investigate vascular endothelial growth factor （VEGF） expression and microvessel density （MVD） on the fibromyoma uteri treated with mifepristone. Methods： VEGF expression and MVD were counted on 60...Objective： To investigate vascular endothelial growth factor （VEGF） expression and microvessel density （MVD） on the fibromyoma uteri treated with mifepristone. Methods： VEGF expression and MVD were counted on 60 cases of the fibromyoma uteri by SP method, including 40 cases of mifepristone treated and 20 cases of untreated patients as controlled group. Results： VEGF positive expression rate and MVD in treated group were 3715% and 9.90 ＋ 5.95, which were lower than those in controlled group （80% and 16.36 ＋ 2.07; P 〈 0.05）. Meanwhile, in treated group, those in marked shrink in tumor size sub-group were lower than in not obvious sub-group （12.0% and 7.89 ＋ 4.36 vs. 80% and 11,29 ＋ 3.10; P 〈 0.05）. Conclusion： VEGF and MVD expression decreases in the fibromyoma uteri after treatment with mifepristone, suggesting that mifepristone could inhibit angiogenesis and blood supply resulting in tumor shrink.展开更多
The transformation of uterine fibroids is common in relation to their development. Giant forms of cystic degeneration are rare. They raise diagnostic difficulties with other pelvic tumors, such as ovarian tumors and l...The transformation of uterine fibroids is common in relation to their development. Giant forms of cystic degeneration are rare. They raise diagnostic difficulties with other pelvic tumors, such as ovarian tumors and leiomyosarcomas. Magnetic resonance imaging specifies the original organ, the volume and the main relationships of fibromyoma with adjacent structures. The diagnosis of certainty is based on laparotomy coupled with histology. The authors illustrate these difficulties by observing a giant cystic degenerative fibroma in a 26-year-old G1P1 woman in the postpartum period.展开更多
Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidem...Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidemiological, clinical, therapeutic and prognostic aspects of uterine fibroids operated in the gynaecology and obstetrics department of the CHU-T. Patients and Method: This was a descriptive cross-sectional study including all patients operated on for uterine fibromyoma in the gynaecology-obstetrics department. The collection mode was retrospective, over a 5-year period from January 1, 2017 to December 31, 2021 in the mother-child department of the CHU-T. Data entry and analysis were carried out on a microcomputer using Epi info 7.2.5 software. Results: We collected 109 cases of uterine fibroids which represented 42.5% of the surgical activities of the gynaecology department. The average age of the patients was 38.9 years ± 7.8. Married women represented 77.1%. Salaried women accounted for 65.1%. The main reasons for consultation were uterine haemorrhage (53.1%), pelvic pain (40.4%) and hypofertility (31.2%). Ultrasound was performed in all patients to help map the fibroid nuclei. The main indication for surgery was haemorrhagic myoma (43.1%). The surgical treatment was conservative (myomectomy) in 58.7% of cases and radical (hysterectomy) in 27.4% of cases. The most frequent postoperative complication was vulvar haemorrhage and the average hospital stay was 4 days ± 1.4. Anatomical pathological examination of the surgical excision specimen carried out on 30 operated patients concluded that uterine leiomyoma was diagnosed in 100% of cases. Conclusion: Patient education for early detection, universal health insurance and cost subsidies could improve the management of this condition.展开更多
Ionizing radiation is widely used in medical practice for both diagnostic and therapeutic purposes. However, they are not devoid of adverse health effects on exposed operators. Therefore, we propose to assess the radi...Ionizing radiation is widely used in medical practice for both diagnostic and therapeutic purposes. However, they are not devoid of adverse health effects on exposed operators. Therefore, we propose to assess the radiological risk of the interventional radiology team of the International Polyclinic of Indénié of Abidjan during the procedures of Embolization of uterine fibromyomas. The effective and equivalent doses to the extremities and crystals were estimated by TLD dosimeters positioned at different body areas selected on the basis of a radiological analysis of the exposure of personnel during five procedures. The analysis of fluoroscopic and record times showed variability in or an average fluoroscopy time of 32.37 min with extremes of 25.14 to 56.32 min;average record time of 0.52 min with extremes of 0.12 min to 1 min. The annual effective doses were respectively, 4.04 mSv, 3.42 mSv, 2.84 mSv;2.28 mSv, in the Radiologist (R), Operator Assistant (O2);Anesthesiologist (A2), Manipulator (M2). The annual equivalent doses to the radiologist’s predominant extremities and lenses were left index and left lens with values of 37.07 mSv and 9.46 mSv. The estimated doses in our study are reassuring from a regulatory point of view of dose limits. The results of our work have shown no significant short-term danger to the health of personnel.展开更多
文摘In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform.?Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.?Patients and Method:?It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.?Results: We collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e.?a frequency of 51.92%.?Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%).?The surgical treatment was conservative in 92.60%. The total hysterectomy performed in 7.40.?Lethality was 1.4%.?Conclusion: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In our context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment is necessary for less invasive surgery.
文摘Objective： To investigate vascular endothelial growth factor （VEGF） expression and microvessel density （MVD） on the fibromyoma uteri treated with mifepristone. Methods： VEGF expression and MVD were counted on 60 cases of the fibromyoma uteri by SP method, including 40 cases of mifepristone treated and 20 cases of untreated patients as controlled group. Results： VEGF positive expression rate and MVD in treated group were 3715% and 9.90 ＋ 5.95, which were lower than those in controlled group （80% and 16.36 ＋ 2.07; P 〈 0.05）. Meanwhile, in treated group, those in marked shrink in tumor size sub-group were lower than in not obvious sub-group （12.0% and 7.89 ＋ 4.36 vs. 80% and 11,29 ＋ 3.10; P 〈 0.05）. Conclusion： VEGF and MVD expression decreases in the fibromyoma uteri after treatment with mifepristone, suggesting that mifepristone could inhibit angiogenesis and blood supply resulting in tumor shrink.
文摘The transformation of uterine fibroids is common in relation to their development. Giant forms of cystic degeneration are rare. They raise diagnostic difficulties with other pelvic tumors, such as ovarian tumors and leiomyosarcomas. Magnetic resonance imaging specifies the original organ, the volume and the main relationships of fibromyoma with adjacent structures. The diagnosis of certainty is based on laparotomy coupled with histology. The authors illustrate these difficulties by observing a giant cystic degenerative fibroma in a 26-year-old G1P1 woman in the postpartum period.
文摘Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidemiological, clinical, therapeutic and prognostic aspects of uterine fibroids operated in the gynaecology and obstetrics department of the CHU-T. Patients and Method: This was a descriptive cross-sectional study including all patients operated on for uterine fibromyoma in the gynaecology-obstetrics department. The collection mode was retrospective, over a 5-year period from January 1, 2017 to December 31, 2021 in the mother-child department of the CHU-T. Data entry and analysis were carried out on a microcomputer using Epi info 7.2.5 software. Results: We collected 109 cases of uterine fibroids which represented 42.5% of the surgical activities of the gynaecology department. The average age of the patients was 38.9 years ± 7.8. Married women represented 77.1%. Salaried women accounted for 65.1%. The main reasons for consultation were uterine haemorrhage (53.1%), pelvic pain (40.4%) and hypofertility (31.2%). Ultrasound was performed in all patients to help map the fibroid nuclei. The main indication for surgery was haemorrhagic myoma (43.1%). The surgical treatment was conservative (myomectomy) in 58.7% of cases and radical (hysterectomy) in 27.4% of cases. The most frequent postoperative complication was vulvar haemorrhage and the average hospital stay was 4 days ± 1.4. Anatomical pathological examination of the surgical excision specimen carried out on 30 operated patients concluded that uterine leiomyoma was diagnosed in 100% of cases. Conclusion: Patient education for early detection, universal health insurance and cost subsidies could improve the management of this condition.
文摘Ionizing radiation is widely used in medical practice for both diagnostic and therapeutic purposes. However, they are not devoid of adverse health effects on exposed operators. Therefore, we propose to assess the radiological risk of the interventional radiology team of the International Polyclinic of Indénié of Abidjan during the procedures of Embolization of uterine fibromyomas. The effective and equivalent doses to the extremities and crystals were estimated by TLD dosimeters positioned at different body areas selected on the basis of a radiological analysis of the exposure of personnel during five procedures. The analysis of fluoroscopic and record times showed variability in or an average fluoroscopy time of 32.37 min with extremes of 25.14 to 56.32 min;average record time of 0.52 min with extremes of 0.12 min to 1 min. The annual effective doses were respectively, 4.04 mSv, 3.42 mSv, 2.84 mSv;2.28 mSv, in the Radiologist (R), Operator Assistant (O2);Anesthesiologist (A2), Manipulator (M2). The annual equivalent doses to the radiologist’s predominant extremities and lenses were left index and left lens with values of 37.07 mSv and 9.46 mSv. The estimated doses in our study are reassuring from a regulatory point of view of dose limits. The results of our work have shown no significant short-term danger to the health of personnel.
