Department of Obstetrics and Gynecology, McMaster University, 1280 Main St. West HSC 3 N 21, Hamilton, ON, L8S 4K1, Canada.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
Reprod Sci. 2022 Apr;29(4):1188-1196. doi: 10.1007/s43032-022-00877-3. Epub 2022 Feb 17.
Uterine fibroids are common benign tumors that occur in up to 80% of women. Approximately half of the women affected experience considerable physical, psychological, and economic burdens and impact on quality of life due to symptoms such as heavy menstrual bleeding, pelvic pain, and infertility. Several medical and surgical options are available to treat uterine fibroids; however, healthcare providers may benefit from practical guidance in the development of individualized treatment plans based on a personalized approach. Medical treatments and minimally invasive procedures are generally preferred by most patients before considering more invasive, higher risk surgical interventions. In general, patient-centered, uterine-preserving procedures may be prioritized based on the patient's goals and the clinical scenario. Occasionally, hysterectomy may be the preferred treatment option for some patients who require definitive treatment. This call-to-action highlights recent challenges to patient care, including radical shifts in physician-patient interactions due to the COVID-19 pandemic and recent changes to evidence-based, clinically approved therapies. This report also reviews contemporary recommendations for women's health providers in the diagnosis and medical and surgical management of uterine fibroids. This call-to-action aims to empower healthcare providers to optimize the quality of care for women with uterine fibroids utilizing the best available evidence and best practices.
子宫肌瘤是一种常见的良性肿瘤，在多达 80%的女性中发生。大约一半受影响的女性由于月经量大、盆腔疼痛和不孕等症状而经历相当大的身体、心理和经济负担，并对生活质量产生影响。有几种医疗和手术选择可用于治疗子宫肌瘤；然而，医疗保健提供者可能需要在制定个体化治疗计划方面获得实用指导，以基于个性化方法制定个体化治疗计划。大多数患者在考虑更具侵入性、风险更高的手术干预之前，通常更倾向于接受药物治疗和微创手术。一般来说，基于患者的目标和临床情况，以患者为中心、保留子宫的手术可能会被优先考虑。偶尔，对于一些需要确定性治疗的患者，子宫切除术可能是首选治疗方法。本行动呼吁强调了最近对患者护理的挑战，包括由于 COVID-19 大流行导致医患互动的彻底转变，以及对基于证据、临床批准的治疗方法的最新更改。本报告还审查了女性健康提供者在诊断和子宫肌瘤的药物和手术管理方面的当代建议。本行动呼吁旨在赋予医疗保健提供者权力，利用最佳现有证据和最佳实践，为患有子宫肌瘤的女性优化护理质量。
