experience of a Medical Hospital. *J Chin Med Assoc* 2010;73(7):360–363. **Part 2**

**Alternatives to Hysterectomy** 

112 Hysterectomy

Yalinkaya A, Güzel A I, Kangal K. Emergency Peripartum Hysterectomy: A 16 years

**9**

*1Egypt 2USA* 

**Medical Treatment of Fibroid to**

**Decrease Rate of Hysterectomy** 

*1Department of Obstetrics and Gynecology, Sohag University Hospitals, Sohag, 2Center for Women's Health Research, Department of Obstetrics and Gynecology,* 

Uterine leiomyomas are the most common benign pelvic tumors in women [1, 2]. They are monoclonal tumors of the smooth muscle cells of the myometrium and consist of large amounts of extracellular matrix that contains collagen, fibronectin and proteoglycan [2, 3]. A thin pseudocapsule that is composed of areolar tissue and compressed muscle fibers usually surrounds the tumors [4]. Leiomyomas may enlarge to cause significant distortion of the uterine surface or cavity. Although they are benign, they commonly result in severe symptoms, such as heavy, irregular and prolonged menstrual bleeding as well as anemia. Uterine leiomyomas have also been associated with numerous other medical disorders, such as infertility, recurrent abortion and preterm labor [5]. These clinical complications negatively impact women's health. Uterine leiomyomas are the most cited indication for more than 600,000 hysterectomies performed in the US annually, and this major surgery is associated with morbidity and mortality as well as a huge economic impact on healthcare

Treatment options for leiomyoma vary. Treatment strategies are typically individualized based on the severity of the symptoms, the size and location of the leiomyoma lesions, the patient's age and their chronological proximity to menopause, and the patient's desire for future fertility. The usual goal of therapy is the relief of the symptoms (which include abnormal uterine bleeding, pain, and pressure). The treatment options range from the use of acupuncture (ancient Chinese method) to the total removal of the uterus and its myoma contents [7]. The gold standard of leiomyoma treatment is surgical intervention. Hysterectomy is the definitive surgical operation, but myomectomy is still commonly performed especially in women who desire future fertility. More recently developed techniques, which include uterine artery embolization (UAE), magnetic resonance-guided focused-ultrasound surgery (MRgFUS) and myolysis, are emerging as minimally invasive

delivery systems that is estimated to be approximately \$2.2 billion/year [6].

**2. Current medical treatment options for uterine leiomyomas** 

**1. Introduction** 

Mohamed Sabry1,2 and Ayman Al-Hendy2

*Meharry Medical College, Nashville, Tennessee,* 

Mohamed Y. Abdel-Rahman1,
