Mifepristone In The Management Of Uterine Myoma

Hysterectomy for fibroids is one of the commonest gynaecological surgeries in India. To reduce the morbidity and mortality associated with the surgery a number of medical treatments have been tried. Mifepristone is one of them and is being used in the recent decade as a more or less effective option in the treatment of myoma. This study was undertaken to evaluate the efficacy and safety of low dose mifepristone in medical management of uterine myomas. Women with symptomatic myomas or myoma of more than 5cm were included in this study. They were given oral mifepristone 25mg per day for 3 months. Patients were followed at 1, 3 and 6 months. The prospective clinical trial was conducted from august 2006 to august 2018 at my clinic. It was found that blood loss reduced significantly in 3 months therapy and the effect started from the first cycle onwards. Amenorrhoea developed in 90% - 95% patients which reverted later

Non-surgical management of uterine myoma / 中国实用妇科与产科杂志

Uterine fibroids are benign diseases with high incidence and unknown pathogenesis.Currently,fibroid excavation or hysterectomy is the most commonly used treatment,but for women who require conservative treatment or with fertility requirements,there is still no optimal treatment option.At present,GnRH agonists/antagonists,selective progesterone receptor antagonists,levonorgestrel sustained release,uterine artery embolization,high-intensity focused ultrasound and other non-traditional surgical treatments provide new treatment options for conservative treatment of uterine fibroids from different angles.

Preoperative differential diagnosis of uterine sarcoma and uterine myoma / 中国实用妇科与产科杂志

Uterine sarcoma is a rare uterine malignant tumor characterized by extremely aggressive behavior with a high recurrence rate and poor prognosis. It remains very challenging to distinguish uterine sarcomas from uterine fibroids prior to surgery because of the similar clinical manifestations and the lack of specific imaging features and tumor markers. An integrated analysis algorism including risk factors,symptoms,imaging analysis(pelvic ultrasound and MRI),and endometrial biopsy is helpful for the preoperative differential diagnosis between uterine sarcomas and uterine leiomyomas.

Ayurvedic Management Of Primary Infertility Due To Polycystic Ovarian Syndrome Associated With Multiple Uterine Fibroids: A Case Report

Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. As one of the leading causes of anovulatory infertility, it is believed that 5-10% of the reproductive-aged female population is living with polycystic ovary syndrome. Ayurveda considers the excellence of 4 factors- Ritu (ovulatory phase), Kshetra (garbhasaya), Ambu (proper nourishment to embryo), and Bija (healthy sperm and ovum) for a successful pregnancy. Impairment to any of these factors leads to Vandhytva or pregnancy failure. This case study helps to plan a treatment protocol for the patient with PCOS having infertility. A 25 yr old female having regular cycles came to OPD of Streeroga of IPGT & RA, having the complaints of weight gain and failure to conceive since 2 year of active married life. On presentation she was a medium sized woman with android body habits and had mild hirsute and acanthosis nigricans over nape of neck. Gynaecological examination revealed a normal sized uterus with no other abnormalities. Sonography revealed bulky ovaries with multiple small follicles with no evidence of ovulation along with small fibroids on anterior wall (1.8cm×1.5cm) and posterior wall (2.7cm×2.8cm). Her husband’s semen analysis was normal. Based on clinical findings and investigation, anovulatory factor infertility due to PCOS was diagnosed along with fibroid. Virechana and Samana were decided due to both of these factors and Sthanyasodhana gana kashaya was selected as Samana drug. Treatment was done for 3 months, during treatment itself ovulation occured and the patient conceived after 3 months. This case being a Krichrasadhya vyadhi, proper care was taken including correction of the lifestyle and food habits. This case will help to understand the importance of Sodhana in gynecological disorders and explore the probable mode of action of Sthanyasodhana gana kashaya which helped in menstrual regulation.

Study on the Preventive and Therapeutic Effect and Its Mechanism of Medicine Pair Decoction Liquid of Curcuma phaeocaulis-Sparganium stoloniferum on Uterine Myoma in Rats / 中国药房

OBJECTIVE:To study the preventive and therapeutic effect and its mechanism of medicine pair decoction liquid of Curcuma phaeocaulis-Sparganium stoloniferum on rats with uterine myoma. METHODS:Rats were randomly divided into normal group,model group,positive group(mifepristone,2.25 mg/kg)and medicine pair decoction liquid group(C. phaeocaulis-S. stolon-iferum decoction liquid,6.0 g/kg),10 in each group. Except for the normal group,rats in other groups were injected Estradiol ben-zoate injection (0.5 mg/kg) intramuscularly every Monday,Wednesday and Friday,for 12 weeks. From the 13th week,rats in modeling group were added Progesterone injection(5 mg/kg)intramuscularly as well as relevant medicines intragastrically,once a day,until the 16th week. After administration,uterine coefficient of rats was detected. HE staining was used to observe the patho-logical changes of uterus and determine the thickness of smooth muscle;immunohistochemical staining was adopted to detect the transforming growth factor β3 (TGF-β3),matrix metalloproteinase 11 (MMP-11) protein expressions in uterus tissue of rats. RE-SULTS:Compared with normal group,uterine coefficient was increased in model group,pathological changes were obvious in uterus,thickness of smooth muscle was increased,TGF-β3 and MMP-11 protein expressions were enhanced(P<0.05 or P<0.01). Compared with model group,above-mentioned changes were improved significantly in positive group and medicine pair decoction liquid groups(P<0.05 or P<0.01). CONCLUSIONS:Medicine pair decoction liquid of C. phaeocaulis-S. stoloniferum shows cer-tain preventive and therapeutic effect on rats with uterine myoma. The mechanism may be associated with downregulating the TGF-β3,MMP-11 protein expressions in uterus tissue.

Effect of gonadotropin-releasing hormone agonist on uterine fibroids and its effect on immune function / 中国生化药物杂志

Objective To investigate the hysteromyoma treated with the gonadotropin releasing hormone agonist(GnRH-a)and the impact on immunologic function.Methods 130 cases selected from the patients with hysteromyoma enrolled from January 2016 to December 2016 in hospital have been randomly divided into two groups.The control group has been treated with mifepristone while the study group GnRH-a.Results The sizes of uterus and myoma of both groups have no significant difference before treatment.After treatment, both of them are significantly improved, and those of the study group is significantly smaller than that of the control group(P<0.05).The levels of serum sex hormone and immunologic function of both groups have no significant difference before treatment.They are both improved after treatment, and the study group is significantly better than the control group(P<0.05).Conclusion Applying GnRH-a therapy to the patients with uterine myoma benefits for improving the therapeutic effect, which can improve the serum sex hormone levels and immunologic function.

RESULTS OF RESEARCH CONDUCTED ON CYTOLOGICAL CHANGES OF DISEASES MOSTLY OCCURRING AMONG WOMEN / Шинэ санаа Шинэ нээлт

First Maternity Hospital in Ulaanbaatar has provided 1890 women, 2508 women and 3728 women in 2012, 2013 and 2014, respectively, for diseases in women. Uterine myoma, ovarian cysts, dysfunctional uterine bleeding, ovariandysfunction and endometriosis are commonly among women. These need to be diagnosed at early stages of the diseases. Endometrial carcinoma is detected in 5% of women under 40 years of age with over amount of hormone estrogen on a base of endometrial hyperplasia.Women with endometrial hyperplasia have 5% possibility to have endometriosis, endometroidcysts, ovarian cancer or uterine myoma and 0.5% possibility to have higher complication of disease. Therefore, we aimed to introduce the practical treatment with cytological analysis as a medical treatment and diagnosis method. The purpose of the research is to highlight the diseases mostly occurring in women, determine cytological changes and differences and improve the differential diagnosis.The research work has been carried out based on reports of cytological analyses undertaken by the National Centre of Pathology for 1310 patients, who were all of patients treated at the Inpatient Care Department in FMH in 2014. This study included in the cytological analyses at the National Centre of Pathology, by using special questinnaries and did retrospective study. 67.7% /888/, 27.8% /365/ and 4.3% /57/ of the above mentioned women were tested with cytological analyses due to surgical diseases, endocrinology diseases and inflammatory diseases, respectively. The average age is 39±58. The uterine myoma, the ovarian cyst and dysfunctional uterine bleeding have been more commonly occurred among the 35 diseases in women as 38.9% /510/, 15.7% /206/ and 16.7%/219/ of the women, respectively. For endometriosis cases, the ovarian endometriosis occurred with 3.7%, the fallopian tube endometriosis occurred 2.4%, the adenomyosis occurred 4.7% and the combined endometriosis occurred 0.5%.Based on the reports of cytological analyses on endometrial hyperplasia, the details show that the simple hyperplasia is 52.4% /178/ and the complex hyperplasia is 47.6% /162/.Compared with women without the HPV, a cervical intraepithelial neoplasia occurs to women with the HPVmore than 20 times. /p<0.001, OR=20.81/. It is statistically important that 2nd stage of adenomyosiscauses atypic cellular changes for 3 times. /p<0.001, OR=3.09/. In women, the uterine myoma, dysfunctional uterine bleeding and ovarian cyst disorders are most common. Average age of women with disease in women is 39.58.Compared with women without the HPV, a cellular change occurs to women with the HPV more than 20 times. /p<0.001, OR=20.81/.The 2nd stage of adenomyosis causes atypic cellular changes for 3 times. /p<0.001, OR=3.09/

Influence of serum Bcl-2 and Bax in patients with myoma of uterus by Jiang Sanqi / 中国生化药物杂志

Objective To investigate effect serum Bcl-2 and Bax in patients with myoma of uterus by Jiang Sanqi.Methods 92 patients with uterine fibroids were selected,and randomly divided into experiment group and control group.Control group of 46 cases treated with goserelin once 3.6 mg every month,subcutaneous injection,mifepristone 12.5 mg,once a day for oral treatment.Experiment group of 46 cases treated with Jiang Sanqi,0.5 g/kg,once a day for boiling water, for 3 months.The level of Bcl-2 and Bax in serum, clinical efficiency, diameter of tumor and complications were compared after treatment.Results The levels of Bcl-2 of experimental group patients was lower than control group, the level of Bax was higher than that of the control group (P<0.05).The total efficiency of experimental group(89.13%)was higher than that of the control group(71.74)%(P<0.05). The experimental group tumor diameter was smaller than the control group(P<0.05).Complications of the experiment was lower than the control group (P<0.05).Conclusion Jiang Sanqi can significantly reduce the serum Bcl-2 of patients with uterine fibroids,increase the expression level of Bax, reduce the uterine fibroids diameter effect, reduce the incidence rate of hormone suppression of drug side effects, has a great significance in clinical.

Hybrid laparoscopic myomectomy: A novel technique

The objective of this study was to report on a new surgical technique, hybrid laparoscopic myomectomy that integrates the advantages of transumbilical laparoendoscopic single-site surgery and those of isobaric laparoscopy, and the initial experience with 14 cases. All of the procedures were performed by a single surgeon who has over 18 years of experience in laparoscopic surgery and 4 years of experience in laparoendoscopic single-site surgery. All cases of hybrid laparoscopic myomectomy were completed safely and effectively without conversion to conventional laparoscopic procedure. The median operative time was 75 minutes (range, 30 to 100 minutes). No postoperative complication was observed. The findings show that hybrid laparoscopic myomectomy is a safe and feasible surgical technique, and therefore can be a feasible, minimally invasive alternative to either abdominal or laparoendoscopic single-site surgery myomectomy.

Effects on Content Changes of Main Components inGui-Zhi Fu-Ling Capsule on Main Pharmacodynamics / 世界科学技术-中医药现代化

The rat model of dysmenorrhea, pelvic inflammation disease (PID), and uterine myoma were established to observe the effect ofGui-Zhi Fu-Ling Capsule (GZFLC) with the changes of main components. The molecular imprinted technology was used to quantitatively knock out main components in GZFLC (the knocked-out ratios were 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%). And the observation was made on the writhing times, latency, and effects on ET-1 and PGF2α of uterine tissues in the pitocin-induced dysmenorrhea rat model. Effects on TNF-α and IL-2 were observed in PID rat model induced by mixed bacteria plus mechanical damages. Effects on the weight and index of uterus, levels of E2 and P in serum were detected on the uterine myoma rat model induced by estrogen-burden. The results showed that the GZFLC efficacy was decreased with gradient knockout of 15 main components. When 10%-40% was knocked out, there was still significant difference compared to the model group (P 0.05). Meanwhile, the GZFLC efficacy was decreased significantly compared to the GZFLC group (P <0.05, orP < 0.01). It was concluded that 15 chemical compounds, which included gallic acid, paeoniflorin, paeonol, and etc., may be the main material basis of GZFLC. Meanwhile, it provided a useful reference for the quality control of main components in GZFLC.

Comparison of clinical effect about hysteroscope and laparotomy in patients with submucous uterine myoma / 中国综合临床

Objective To compare the clinical effect about hysteroscope and laparotomy in patients with submucous uterine myoma. Methods Eighty-four patients with submucous uterine myoma were randomly divided into control group(n=42)and observation group(n=42). The patients in the control group were given laparotomy treatment,while in the observation group were given hysteroscope treatment. The intraoperative and postoperative conditions between the two groups were recorded and compared. Results The operation time, intraoperatve blood volume,postoperative anal exhaust time,postoperative pain intensity( judged by VAS)and hospital stays periods in observation group were(52. 5 ± 9. 6)min,(84. 6 ± 16. 7)ml,(21. 5 ± 3. 6)h,(3. 6 ± 1. 4)scores and(5. 4 ± 1. 8)d,significant lower than those in control group((72. 6 ± 13. 4)min,(116. 8 ± 28. 4)ml,(29. 8 ± 5. 4)h,(1. 8 ± 0. 5)scores,(9. 6 ± 2. 4)d),and the differences were significant( t=5. 468,4. 263,4. 438,6. 283;P =0. 006,0. 018,0. 024,0. 001,0. 002 ). While the hospitalization costs in observation group was(7394. 9 ± 1164. 8)yuan,higher than that of the control group((5 428. 9 ± 824. 5) yuan;t=4. 647,P=0. 036). There were no statistical significant in terms of recurrence rate between the two groups( 20. 5% vs. 19. 6%;χ2 = 0. 236,P = 0. 637 ). Conclusion Treatment of hysteroscope surgery on submucosal myoma of uterus has the advantages of small trauma and quick recovery and it is an ideal surgical method for uterine myoma.

Diagnostic value of Matrix metalloproteinase-9 and Epidermal growth factor in uterine myoma / 中国综合临床

Objective To discuss the diagnostic value of Matrix metalloproteinase-9 (MMP-9) and Epidermal growth factor (EGF) in uterine myoma.Methods Seventy-three patients with uterine leiomyoma treated by surgery as treatment group,and 65 healthy women were selected as control group.The levels of MMP9 and EGF in both groups were detected by enzyme-linked immunosorbent assay method.Results The levels of MMP-9and EGF in treatment group were significantly higher than those of control group((1.72±0.36) mg/L vs.(1.28±0.25) mg/L, (342.16± 128.65) ng/L vs.(209.84± 100.34) ng/L;t =8.241,6.678;P ＜0.01).There were no relationships between the levels of MMP-9 and EGF with maximum diameter of uterine myoma (P ＞0.05).Conclusion Serum levels of MMP-9 and EGF have some clinical value in diagnosing uterine leiomyoma.

Application of prone-straddle position for transvaginal hysteromyomectomy in the posterior wall of the uterus / 局解手术学杂志

Objective To discuss the safety and advantages of prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus. Methods The clinical data of patients who were admitted into our hospital from March 2013 to Janaury 2015 and received transvaginal hysteromyomectomy were retrospectively analyzed. They were divided into group A ( prone-straddle position, 30 cases) and group B (traditional lithotomy position,24 cases). The exposure of operative field, convenience of operation, time of the placement, time of operation, patient satisfaction, as well as patients’ heart rate, blood pressure, and oxyhemoglobin saturation were observed and ana-lyzed. Results Compared with the lithotomy position, there were significant differences in the time of the placement and the time of opera-tion in the patients treated by prone-straddle position. The patients with prone-straddle position cooperated well, and there was no obvious discomfort. Their vital signs were stable during the operation. The operative field during prone-straddle position exposed better and it was more convenient which make the operation became easier for both the operators and nurses. Conclusion Prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus is safe and practicable, and it is valuable for clinical application.

Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization

OBJECTIVE: To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. MATERIALS AND METHODS: We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. RESULTS: The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. CONCLUSION: Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

Presentación de una paciente con mioma gigante del útero / Report of a Patient with Giant Uterine Myoma

Se presentó una paciente de 32 años de edad, de la raza negra, con historia obstétrica de dos abortos espontáneos en el primer trimestre del embarazo, nulípara, que acudió a la Consulta de Ginecología en enero de 2010 en el Hospital de Kabgayi, Rwanda, África, y refirió aumento de volumen del abdomen y además, constipación, tenesmo vesical y sangrados abundantes, que le causaban anemia severa. Después del interrogatorio y examen físico se encontró una tumoración gigante de la cavidad abdominal que ocupaba todo el hemiabdomen inferior y sobrepasaba la cicatriz umbilical que parecía ser un mioma uterino, diagnóstico que se corroboró posteriormente con la ultrasonografía abdominal. Se decidió tratamiento quirúrgico con histerectomía total, y se obtuvo una pieza correspondiente a un mioma uterino con un peso de 4,7 kg.

A 32- year- old patient of black race, with obstetrical history of two spontaneous abortions in the first trimester of pregnancy, nullipara, who was attended at Gynecology Service in January 2010, Kabgayi Hospital in Rwanda, Africa. The patient´s abdomen increased and the clinical manifestations were constipation, vesiacal tenesmus and profuse bleeding that caused severe anemia. After the patient’s interview application and the physical examination was done a giant tumor of the abdominal cavity was found that filled the lower abdomen and surpassed the umbilicus that clinically impressed: a uterine myoma that was later confirmed by abdominal ultrasonography. Surgical treatment was performed with total hysterectomy, and showed a giant tumor of 4.7 kg.

Leiomiomatose uterina: revisão / Uterine leiomyomatosis: review

Os leiomiomas uterinos são tumores monoclonais que se originam de uma mutação somática em um miócito progenitor. Representam a neoplasia benigna mais comum do útero. A causa precisa relacionada ao seu desenvolvimento ainda não foi totalmente esclarecida. As apresentações clínicas mais frequentes são o sangramento anormal, a dor e pressão pélvicas, massa pélvica não diagnosticada anteriormente e infertilidade. O diagnóstico baseia-se na história clínica, no exame físico, que pode ser completamente normal em alguns casos, e nos achados de exames complementares, como a ultrassonografia endovaginal, a histerossonografia e a ressonância magnética. O tratamento varia de acordo com a apresentação clínica e pode ser expectante, clínico ou cirúrgico.

The uterine leiomyomas are monoclonal tumors that originate from a somatic mutation in a myocyte progenitor and are the most common benign tumor of the uterus. The precise cause related to its development has not been fully clarified. The most common clinical presentations are abnormal vaginal bleeding, pelvic pain and pressure, previously undiagnosed pelvic mass, and infertility. The diagnosis is based on clinical history, physical examination, which may be completely normal in some cases, and the findings of laboratory tests such as transvaginal ultrasound, the sonohysterography, MRI. Treatment varies according to clinical presentation and may be expectant, medical or surgical.

An Incidentally Found Inflamed Uterine Myoma Causing Low Abdominal Pain, Using Tc-99m-Tektrotyd Single Photon Emission Computed Tomography-CT Hybrid Imaging

We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

Investigation of the anaesthetic effect of propofol combined with remifentanil by target-controlled infusion during gynecological laparoscopic myomectomy / 中国综合临床

Objective To investigate the anaesthetic effect of propofol combined with remifentanil by target-controlled infusion (TCI) used in gynecological laparoscopic myomectomy.Methods Fifty cases,who were scheduled for gynecological laparoscopic myomectomy in our hospital from June 2010 to June 2011,was randomly divided into propofol combined with remifentanil group (n =25) and inhalation anesthesia (remifentanil combined with sevoflurane) group (n =25).The heart rate and blood pressure were recorded at the time of before induction of anesthesia (T0),30 min after carbon dioxide pneumoperitoneum,the end of operation and 3 min after extubation.The awake time,time of extubation and surgery time were also recorded.Results The hemodynamics were kept stable in propofol combined with remifentanil group,and there were no significant difference with respect to SABP,DABP and heart rate at all time points compared with baseline (P ＞0.05) in propofol group.However,in inhalation anesthesia group,SABP,DABP and heart rate were increased significantly at 30 min after carbon dioxide pneumoperitoneum and 3 min after extubation when compared with baseline (P ＜ 0.05) and were higher than those of propofol group (P ＜ 0.05) at counterpart time points.In inhalation anesthesia group,the awake time ((9.3 ± 1.5) min vs (4.9 ± 1.1) min,t =10.56,P =0.017) and time of extubation ((12.9 ± 2.4) min vs.(6.8 ± 1.2) min,t =12.36,P =0.01) were significantlv longer than that of propofol group (P ＜ 0.05).Conclusion Propofol combined with remifentanil TCI-based anesthesia could achieve the optimal hemdynamic stability during anesthesia maintance and better recovery profile from anesthesia in gynecological laparoscopic myomectomy.

Diagnóstico ecográfico de mioma uterino en mujeres con síntomas ginecológicos / Ultrasound diagnosis of uterine myoma in women with gynecological symptoms

Se realizó un estudio descriptivo y transversal de 76 pacientes atendidas en el Departamento de Ultrasonido del Hospital "Carlos Manuel de Céspedes" de Bayamo, Granma, desde junio de 2011 hasta enero de 2012, con vistas a describir las características ecográficas del mioma uterino en mujeres con síntomas ginecológicos. Entre las variables analizadas figuraron: edad, color de la piel, hallazgos ecográficos y correspondencia entre el diagnostico presuntivo y el ecográfico. En la serie prevalecieron las diagnosticadas con mioma uterino, el grupo etario de 15-45 años y las féminas de piel negra. Asimismo, predominaron los miomas múltiples y de localización intramural. Las complicaciones que primaron fueron la degeneración quística y las calcificaciones. No hubo total correspondencia entre las indicaciones médicas presuntivas de miomas y el diagnóstico ecográfico definitivo.

A descriptive and cross-sectional study was conducted in 76 patients attended in the Ultrasound Department of "Carlos Manuel de Céspedes" Hospital in Bayamo, Granma, from June 2011 to January 2012, in order to describe the sonographic characteristics of the uterine myoma in women with gynecological symptoms. Among the analyzed variables were age, race, sonographic findings and correspondence between the presumptive and sonographic diagnosis. Those diagnosed with uterine myoma, age group of 15-45 years and black women prevailed in the series. Also, multiple myomas and those of intramural location prevailed. Cystic degeneration and calcifications were the prevailing complications. There was not total correspondence between the presumptive medical indications of myomas and the final ultrasound diagnosis.

Hemorragia uterina anormal orgánica / Abnormal organic uterine bleeding

Introducción: la hemorragia uterina anormal es cualquier sangrado que difiera del patrón menstrual, su prevalencia es del 30%. El 25% corresponden a causas orgánicas. Su importancia radica en que produce alteraciones sociales, sexuales, profesionales, temores de sufrir enfermedades ginecológicas malignas e implicaciones económicas. Objetivos: determinar la prevalencia de hemorragia uterina anormal de etiología orgánica e identificar los motivos de consulta, patologías causantes y tratamiento realizado. Materiales y métodos: estudio observacional descriptivo, de corte transversal y retrospectivo, con revisión de 270 fichas de pacientes que acudieron al consultorio de Ginecología de la Cátedra y Servicio de Ginecología y Obstetricia de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción entre enero 2007 a diciembre 2011. Resultados: la prevalencia de hemorragia uterina anormal de causa orgánica fue 16,3%. El principal motivo de consulta fue la hipermenorrea (63,3%). Los diagnósticos finales fueron mioma uterino (57%) y las patologías endometriales. La mayoría fue sometida a cirugía (71%) y 38% presentó anemia. Conclusiones: la prevalencia de hemorragia uterina anormal de causa orgánica fue 16,3%, siendo el mioma uterino su principal origen.

Introduction: Abnormal uterine bleeding is any bleeding that differs from menstrual pattern, its prevalence is 30%, of which 25% are of organic causes. Its importance lies in producing social, sexual and professional disturbances, fears of having malignant gynecological diseases and its economic implications. Objectives: To determine the prevalence of abnormal uterine bleeding and identify organic etiology complaints, causing diseases and established treatment. Materials and methods: observational descriptive, cross-sectional and retrospective study with review of 270 records of patients who attended the office of Gynecology of the Chair and Department of Gynecology and Obstetrics, Faculty of Medicine, National University of Asunción between January 2007 to December 2011. Results: The prevalence of abnormal uterine bleeding of organic cause was 16.3%. The chief complaint was menorrhagia (63.3%). Final diagnoses were uterine myoma (57%) and endometrial pathologies. Most underwent surgery (71%) and 38% had anemia. Conclusions: The prevalence of abnormal organic uterine bleeding causes was 16.3%, with uterine myoma as its main source.