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The following is a summary of “An update on the management of uterine fibroids: personalized medicine or guidelines?” published in the September 2024 issue of Obstetrics and Gynecology by Mension et al.
Significant progress has been made in understanding the development of uterine fibroids (UFs) forming from smooth muscle cells due to hormonal and genetic factors. Although 50–75% of UFs are non-clinically relevant when asymptomatic, common symptoms include abnormal uterine bleeding (AUB), pelvic pain, and reproductive issues. The first diagnostic tool for UFs is typically transvaginal ultrasound (TVUS), which often provides a precise diagnosis.
Researchers conducted a retrospective study exploring diagnostic and treatment approaches for uterine fibroids, focusing on the use of TVUS for diagnosis and the variety of available therapeutic options, individualized based on symptoms and clinical context.
They utilized TUS to diagnose UFs, employing different UF reporting systems to standardize findings. In some cases, complementary imaging techniques were required. Depending on symptoms, various treatment options were individualized, including tranexamic acid, levonorgestrel intrauterine devices, oral contraceptives, selective progesterone receptor modulators, and GnRH antagonist therapies. Surgical procedures were also considered when necessary.
The results showed that in asymptomatic UFs, no medical or surgical intervention was required. However, in symptomatic patients, treatment was tailored to each case, with considerations beyond just UF type and morphology. The variability of UF stem cells contributed to differences in treatment response.
Investigators concluded that TVUS is a crucial tool for diagnosing uterine fibroids. Treatment should be tailored to symptoms, but differences in UF stem cells may impact effectiveness. Medical and surgical options should be discussed with patients to find the best fit.
Source: sciencedirect.com/science/article/pii/S2949838424000227#bib0055
