Successful pregnancies following individualized treatment for diffuse uterine leiomyomatosis: A report of 5 cases.
10.11817/j.issn.1672-7347.2025.240583
- Author:
Shudan CHEN
1
,
2
;
Sili HE
3
;
Ruizhen LI
4
;
Chunxia CHENG
2
,
5
Author Information
1. Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China. chenshudan07@
2. com.
3. Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
4. Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China. 472527934@qq.com.
5. Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China. darlingch@
- Publication Type:English Abstract
- Keywords:
diffuse uterine leiomyomatosis;
fertility preservation;
high-intensity focused ultrasound;
hysteroscopic myomectomy;
individualized treatment;
laparoscopic myomectomy
- MeSH:
Humans;
Female;
Pregnancy;
Leiomyomatosis/therapy*;
Uterine Neoplasms/therapy*;
Adult;
Retrospective Studies;
Fertility Preservation/methods*;
Hysterectomy;
Uterine Myomectomy/methods*;
High-Intensity Focused Ultrasound Ablation;
Pregnancy Outcome
- From:
Journal of Central South University(Medical Sciences)
2025;50(6):1099-1105
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:Hysterectomy remains the only definitively effective treatment for diffuse uterine leiomyomatosis (DUL). However, no standardized management strategy exists for DUL patients wishing to preserve fertility. This study summarizes and analyzes 5 cases of individualized treatment in DUL patients desiring fertility preservation, aiming to provide a clinical reference for personalized management of similar patients.
METHODS:We retrospectively analyzed the clinical data of 5 DUL patients with fertility intentions admitted to the Department of Obstetrics and Gynecology at Third Xiangya Hospital of Central South University. To preserve fertility, individualized treatment plans were selected based on clinical manifestations and fibroid distribution. One patient received high-intensity focused ultrasound (HIFU); one underwent hysteroscopic myomectomy (HM) combined with laparoscopic myomectomy (LRM); one underwent HIFU combined with HM and LRM; one received drug therapy combined with staged HM; and one underwent HIFU combined with staged HM and drug therapy. Treatment outcomes and pregnancy results were analyzed.
RESULTS:After treatment, all 5 patients showed marked improvement in menstrual volume or dysmenorrhea symptoms and significant reduction in uterine volume; mild intrauterine adhesions occurred in 3 cases. All 5 patients achieved successful pregnancy. One patient with chronic hypertension developed severe preeclampsia at 34 weeks and underwent cesarean section, while the remaining 4 delivered at term by cesarean section. Three cases of placenta accreta and 2 cases of postpartum hemorrhage occurred. During long-term follow-up, one patient underwent hysterectomy 2 years postpartum due to increased menstrual volume, while the other 4 remained stable.
CONCLUSIONS:Individualized treatment tailored to DUL patients' conditions can preserve fertility, support successful pregnancy, and achieve favorable pregnancy outcomes.
