TAILORING THE DIAGNOSIS FOR THERAPEUTIC AND SURGICAL TREATMENT OF UTERINE FIBROIDS: A COMPREHENSIVE REVIEW
Keywords:
Leiomyoma, uterine fibroids, pathophysiology, adenomyosis, endocervical polyps, menorrhagiaAbstract
These benign tumors are the most frequent tumors of the female reproductive system. These hormone-responsive tumors can present with a wide range of symptoms, from severe symptoms such as pelvic discomfort, excessive menstrual flow, reproductive dysfunction, and a marked reduction in quality of life, to asymptomatic cases. The clinical relevance of size and quantity concerns, as well as the classification of fibroids by site (subserosal, intramural, submucosal, and cervical), are discussed. Focusing on genetic abnormalities such as MED12 and HMGA2, the effects of estrogen and progesterone, and important risk factors such as ethnicity, reproductive, and environmental variables, this review further clarifies the intricate pathophysiology of fibroids. The therapeutic options are thoroughly reviewed with a focus on fertility-sparing tactics. These include minimally invasive procedures such as MRI-guided focused ultrasound surgery (MRgFUS) and uterine artery embolization (UAE), medical management with hormonal and non-hormonal agents, and surgical options such as myomectomy and hysterectomy. Finally, new pharmacological medicines, minimally invasive technology advancements, genetic and molecular targeting, and the combination of artificial intelligence and personalized medicine to improve treatment are mentioned as future directions in fibroid research and therapy. The purpose of this review is to provide researchers and doctors with a thorough and up-to-date resource to comprehend and address the health issues that uterine fibroids present in women.
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