CNKI, PubMed and other databases were retrieved to extract eligible randomized controlled trial(RCT) about modified Xuefu Zhuyu Decoction(MXZD) combined with Western medicine(trial group) versus Western medicine alone(control group) in the treatment of leiomyoma. Therefore, a total of 25 RCTs were included, involving 2 328 patients. Bias risk evaluation tool in Cochrane Handbook 5.1.0 was used for evaluating the quality of these RCTs. Meta-analysis was performed for the reported indicators, including total efficiency, serum hormone level [progesterone(P), luteinizing hormone(LH), estradiol(E_2), follicle stimulating hormone(FSH)], uterine size, fibroids size and adverse reactions by using Stata 14.0 software. Meta-analysis showed that the total efficiency(RR=1.21,95%CI[1.17,1.25],P<0.05) of trial group was better than that of control group. Serum hormone level(WMD_P=-3.86,95%CI[-4.31,-3.41],P<0.05; WMD_(LH)=-3.64,95%CI[-4.47,-2.82],P<0.05; WMD_(E_2)=-39.99,95%CI[-53.45,-26.52],P<0.05; WMD_(FSH)=-3.79,95%CI[-4.86,-2.72],P<0.05), uterine size(WMD=-50.02,95%CI[-55.98,-44.06],P<0.05), fibroids size(WMD=-15.79,95%CI[-18.11,-13.46],P<0.05) and adverse reactions(RR=0.65,95%CI[0.48,0.88],P<0.05) of trial group were all lower than those of control group, with statistical significances. Trial sequential analysis(TSA) was performed by using TSA 0.9 software, and showed a reliable therapeutic effect of the experimental group. In short, our study indicated that modified Xuefu Zhuyu Decoction combined with Western medicine had a better therapeutic effect on leiomyoma than Western medicine alone, but more high-quality studies are needed to verify this conclusion in the future.
Drugs, Chinese Herbal ; Humans ; Leiomyoma/drug therapy* ; Medicine

OBJECTIVE: The purpose of this study was to establish guidelines for using uterine artery embolization for the treatment of uterine leiomyomas accompanied by adenomyosis in Korea. This study was performed to investigate 1) the effects of uterine embolization on leiomyoma accompanied by adenomyosis, 2) the outcome of uterine embolization according to the embolization materials used, 3) the relationship between the Resistance Index (RI) and the change in uterine volume. MATERIALS AND METHODS: We performed a retrospective study on 37 women who had uterine leiomyomas accompanied by adenomyosis. Bilateral uterine artery embolization was performed over a period of 17 months in 37 patients (age range 25 - 65) experiencing pain, hypermenorrhea, urinary frequency, etc. due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. RESULTS: All procedures were technically successful. Mean clinical follow-up time was 12.8 months. Minor complications occurred in 82% patients following the procedure. After follow-up imaging, the median uterine volume decreased by 34.4% and the dominant myoma volume decreased by 86%. There was no statistical difference in the uterine volume reduction and the dominant myoma size reduction, whether the occluding agent was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, or gelfoam, and whether the ultrasound measured Resistance Index value before the procedure was low or high. CONCLUSION: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas, who no longer desire fertility, but who wish to avoid surgery or are poor surgical risks. According to the results of our study, adenomyosis should not be considered as a contraindication for uterine artery embolization. However, because little data is available about the subsequent reproductive potential following this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted regarding the choice of occluding agent and the role of the Resistance Index.
Adult ; Arteries ; *Embolization, Therapeutic ; Female ; Human ; Leiomyoma/*therapy ; Middle Age ; Uterine Neoplasms/*therapy ; Uterus/*blood supply

No abstract available.
Female ; Humans ; Leiomyoma/*therapy ; Magnetic Resonance Imaging, Interventional/*methods ; Uterine Artery Embolization/*methods ; Uterine Neoplasms/*therapy

OBJECTIVE: This study was undertaken to evaluate the usefulness of laparoscopic myomectomy after hormone replacement therapy in postmenopausal women with uterine myoma. METHODS: The total number of patients with uterine myoma in a postmenopausal women from March 1999 to December 2002 in Department of Obstetrics and Gynecology in Chonnam University Hospital was 137. Patients underwent laparoscopic myomectomy are 12 (Group B) and only hormone replacement therapy without operation are 83 (Group A). The others are not undertaken any treatment (Group C). The number and size of myoma and the development of estrogen-dependent tumor periodically followed up. RESULTS: There were significant differences among three groups with respect to myoma dimension, number. And the risk of developing of estrogen dependent tumor is not increased with Hormone replacement therapy in postmenopausal women. So, laparoscopic myomectomy in a postmenopausal patients would be performed carefully. CONCLUSION: We are not sure whether HRT increases the number and size of the myoma and malignant change when compared with untreated with postmenopausal women. So, laparoscopic myomectomy in a postmenopausal patients would be performed carefully. Further prospective studies with larger groups and a long-term would be helpful in deciding which treatment modality would be appropriate in a postmenopausal patient with myoma.
Estrogens ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Jeollanam-do ; Leiomyoma* ; Myoma ; Obstetrics ; Postmenopause

OBJECTIVE: The purpose of this study was to study the clinical efficacy of Levonorgestrel-releasing intrauterine system (Mirena(R)) for patients who have abnormal uterine bleeding before menopause or sustaining vaginal spotting during postmenopaual hormone replacement therapy. METHODS: Between June, 2001 and June, 2003, forty six premenopausal women with abnormal uterine bleeding such as menorrhagia and intermenstrual bleeding who did not prefer surgical treatment (Group 1) and twenty four postmenopausal patients with vaginal spotting (Group 2) were included in this study. The various parameters such as uterine bleeding, dysmenorrhea, volume changes of myoma or adenomyosis, and endometrial thickness were evaluated by transvaginal ultrasound examination before and after Levonorgestrel- releasing intrauterine system usage. RESULTS: A significant reduction in abnormal bleeding (26.3 vs 11.0) (p<0.0001) and dysmenorrhea (11.6 vs 6.1) (p<0.0001) were noticed. However, there was no significant change in volume of uterine myoma (40.0 vs 11.3) (p=0.282) and adenomyosis (103.0 vs 95.83) (p=0.266) before and after Mirena(R) insertion in Group 1. Vaginal spotting during hormone replacement therapy disappeared completely in 18/24. Also there was a significant reduction in endometrial thickness (6.3 vs 4.9) (p<0.0001) after Mirena(R) insertion in both group 1 and group 2. CONCLUSION: Levonorgestrel-releasing intrauterine system insertion was acceptable and convenient therapeutic modality for abnormal uterine bleeding of premenopausal abnormal uterine bleeding and vaginal spotting during the postmenopausal hormone replacement therapy.
Adenomyosis ; Dysmenorrhea ; Estrogen Replacement Therapy ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Leiomyoma ; Menopause ; Menorrhagia ; Metrorrhagia ; Myoma ; Ultrasonography ; Uterine Hemorrhage*

OBJECTIVETo evaluate the effect of ultrasound-guided focused ultrasound ablation (US-FUA) in the treatment of intramural, submucosal and subserosal uterine fibroids.

METHODSWe prospectively assessed the efficacy of US-FUA for treatment of symptomatic uterine fibroids by determining the volume ablation ratio immediately after the treatment and evaluating the volume changes of the uterine fibroids on contrast-enhanced MRI at 6 and 12 months after the treatment. The symptom severity score (SSS) was examined before and at 6 and 12 months after the treatment.

RESULTSA total of 110 women with 145 symptomatic fibroids undergoing US-FUA between August 2011 and December 2012 were enrolled. The fibroids were located intramurally in 72 (49.7%), submucosally in 49 (33.8%) and subserosally in 24 (16.6%) patients, who had comparable mean volume ablation ratios [(93.± 13.1)% vs (94.9 ± 9.3)% vs (89.6 ± 19.3)%, P>0.05]. The volume of the treated fibroids was reduced by (47.3 ± 20.8)%, (70.3 ± 22.2)% and (47.8 ± 13.6)% at 6 months after US-FUA and by (58.9 ± 19.9)%, (82.0 ± 21.2)%, and (50.5 ± 17.8)% at 12 months, respectively, demonstrating a more obvious volume reduction for submucosal fibroids (P<0.05). The SSS scores of the 3 groups before treatment were 29.1 ± 15.2, 34.8 ± 14.5 and 26.6 ± 23.4, respectively, which decreased significantly to 18.4 ± 15.8, 15.5 ± 10.7, and 11.6 ± 11.7 at 6 months (P<0.05) and to 18.9 ± 13.2, 16.8 ± 14.0, 11.5 ± 9.1 at 12 months (P<0.05). No major complications occurred in these patients during the 12-month follow-up.

CONCLUSIONUS-FUA can yield high ablation ratios for intramural, submucosal and subserosal fibroids and result in significant volume reduction and symptomatic improvement at 6 and 12 months after the treatment, suggesting its value as a new noninvasive option for fibroid treatment in patients who wish to preserve the uterus.

Female ; Follow-Up Studies ; High-Intensity Focused Ultrasound Ablation ; Humans ; Leiomyoma ; therapy ; Magnetic Resonance Imaging ; Treatment Outcome ; Uterine Neoplasms ; therapy

Uterine leiomyosarcoma is a rare malignant tumor, and distant metastasis to skull bone is very uncommon. We experienced a case of parietal skull bone metastasis from uterine leiomyosarcoma in a 52-year-old woman who had undergone simple total hysterectomy and bilateral salpingoophorectomy with the diagnosis of uterine myoma. We treated this patient with combination chemotherapy using cisplatin and adriamycin and radiotherapy after craniectomy. She is alive now without particular symptoms. We report this case with a brief review of some literatures.
Cisplatin ; Diagnosis ; Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Leiomyosarcoma* ; Middle Aged ; Neoplasm Metastasis* ; Rabeprazole ; Radiotherapy ; Skull*

Growth of uterine myoma to huge size after menopause is very unusual especially when postmenopausal pattern is not on hormone replacement therapy. Recently we experienced 6000g of myoma uteri grown after menopause in 59 year old patient who visited emergency room due to vaginal bleeding for 10 days. After diagnostic work-up to rule out malignancy, she underwent exploration and huge uterine myoma was removed by total hysterectomy and bilateral salpingoopphorectomy. This patient is presented here with brief review of related literatures.
Emergency Service, Hospital ; Female ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Leiomyoma* ; Menopause ; Middle Aged ; Myoma ; Uterine Hemorrhage ; Uterus

Abdomen ; anatomy & histology ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Leiomyoma ; therapy ; Middle Aged

In treating women with leiomyoma and who wish to preserve their uterus, laparoscopic uterine artery ligation or uterine artery embolization should be considered as possible options. This study was performed to evaluate the efficacy of laparoscopic uterine artery ligation and uterine artery embolization in treating uterine myoma. The treatment outcomes of 23 patients who underwent uterine artery embolization and 17 laparoscopic uterine artery ligation were evaluated. The uterine volume reduced 3 months after uterine artery embolization, but thereafter no significant changes were observed. On the other hand, the uterine volumes were only slightly reduced 3 months after laparoscopic uterine artery ligation, and slightly more reduced 6 months later. The average reduction in the case of laparoscopic uterine artery ligation was about 58.5%. After laparoscopic uterine artery ligation, 20% of the patients complained of vaginal spotting. Furthermore, the mechanism of volume reduction was evaluated using specimens obtained from a biopsy taken after each procedure. The results suggested that laparoscopic uterine artery ligation results mainly in physiologic cell death, that is apoptosis, whereas, the corresponding result is cell necrosis for uterine artery embolization. Uterine artery embolization and laparoscopic uterine artery ligation are both effective in relieving the symptoms caused by uterine myoma, and therefore both procedures can be used in place of hysterectomy or myomectomy.
Adult ; Arteries ; *Embolization, Therapeutic ; Female ; Human ; *Laparoscopy ; Leiomyoma/*therapy ; Ligation ; Support, Non-U.S. Gov't ; Treatment Outcome ; Uterine Neoplasms/*therapy ; Uterus/*blood supply