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Uterine fibroids are the most common pelvic benign tumours occurring in women of reproductive age. Current treatment options include surgical procedures, pharmacological therapies, and minimally invasive procedures. The most commonly applied and accepted minimally invasive procedure used in the treatment of symptomatic uterine fibroid is uterine artery embolisation (UAE). Uterine artery embolisation is a minimally invasive procedure that can be used either as an auxiliary method or the main treatment method of symptomatic uterine fibroids. We would like to present the application of pre-operative UAE before hysterectomy in anaemic women with giant uterine fibroid (21.9 × 14.9 × 10.4 cm) and HIV-associated nephropathy. Among the possible treatment options for uterine fibroids in cases like the one presented in our manuscript, hysterectomy is the treatment of choice. However, surgical treatment in a patient with severe comorbid conditions and giant uterine fibroid carries serious risk of perioperative complications. Pre-operative UAE decreases such risk by reducing blood loss during hysterectomy and shortening operation/anaesthesia time. Although the benefits of pre-operative UAE before planned myomectomy or hysterectomy in high surgical risk patients with large fibroids has yet to be confirmed in a well-designed clinical trial, this procedure seems to be a promising tool to reduce the risk of perioperative complications in such patients. [ABSTRACT FROM AUTHOR]

Uterine fibroids are benign tumors that arise from the smooth muscle tissue of the uterus and are the most common tumors in women. Due to their high prevalence, costs for the health care system and the substantial impact on women's quality of life, they are a significant public health concern. Previous literature on the impact of diet on the occurrence, growth and symptoms of fibroids is limited. Recently, many papers have been written on this topic. A scoping review of PubMed and Cochrane databases was performed using the following keywords: uterine fibroids, antioxidants, diet, diet, vegetarian, vegetables, fruits, meat and soy foods, dairy products, tea, vitamin D, vitamin C, ascorbic acid. Preliminary research has shown a beneficial effect of vegetable and fruit consumption on the occurrence of fibroids. A relationship between hypovitaminosis D and an increased risk of fibroids has also been demonstrated. Studies on epigallocatechin gallate showed its apoptosis-promoting and antifibrinolytic effect in fibroid cells. Initial results are promising, but further randomized trials are needed to draw firm conclusions about the effects of diet and nutrients on uterine fibroids. [ABSTRACT FROM AUTHOR]

This article discusses the use of intrauterine gel with lidocaine in office hysteroscopy for a patient with an increased risk of complications following general anesthesia due to muscular dystrophy. The patient, a 51-year-old woman with a complex medical history, underwent the procedure under local anesthesia with the application of lidocaine gel. The procedure was successful, with minimal pain reported by the patient and no complications or increased bleeding. The article suggests that the use of lidocaine gel shows promise in managing patients with a higher risk of complications from general anesthesia. [Extracted from the article]

Objectives: To identify specific features of vulvodynia in prepubertal girls, highlight potential triggers and concomitant diseases, outline diagnostic criteria is neglected problem in adolescent gynecology. Material and methods: A retrospective study, based on medical records of an outpatient clinic, a cohort of 54 vulvodynia cases was evaluated, aged 3-10 years, seen between January 2016 and July 2018. Results: The study cohort presented with pain (61%), sometimes aggravated at night, pruritus (44%) and a range of other varied and unusual vulvar complaints (26%). Concomitant diseases and/or psychological problems were present in 61% of cases. Overactive pelvic muscles accompanying symptoms like urological or gastrological problems were noted in half of children. Several potential triggers were identified in a third of the cases that were emotionally stressful to the children. From the commencement of symptoms, 93% of the girls have consulted more than one doctor with 43% seeing more than three doctors, without receiving a diagnosis of vulvodynia. Conclusions: A diagnosis of vulvodynia needs to be considered in the absence of vulva pathology with wide range of vulvar pain, pruritus and discomfort. All persistent or recurrent vulvar discomfort must be taken into consideration as a vulvodynia symptom, also various non-specific, worrisome complaints. Comorbid urological and gastrological symptoms associated with overactive pelvic muscles should not be overlooked. Chronic pain can be triggered by the psychological distress in some prepubertal girls. Proper diagnosis may prevent long-term negative sequelae, what emphasizes the need for professional education of healthcare providers in adolescent vulvar pain and discomfort. [ABSTRACT FROM AUTHOR]

Objectives: To present preliminary results of minimally invasive endovascular embolization as a treatment of symptomatic adenomyosis or adenomyosis with fibroids and to assess the long-term clinical outcome. Material and methods: Between 2015 and 2020 twelve patients with symptomatic adenomyosis or adenomyosis with fibroids underwent uterine artery embolization (UAE). All patients were evaluated in terms of patient's overall satisfaction, relief of clinical symptoms, reintervention and hysterectomy as well as menopause rates. Results: Mean age on admission was 48 years. Reported symptoms included: dysmenorrhea with the mean VAS score of 7.8, menorrhagia and problems with urination. Successful embolization was achieved in all patients (100%). A reduction in pelvic pain intensity assessed using VAS was observed in 11/12 (92%) of the patients -- pain decreased by 6.2 points on average (from 7.8 to 1.6 pts). In one patient (8%) the recurrence of pain was observed. All patients reported decrease of menstrual bleeding and consequently improvement of everyday life quality. Avoidance of hysterectomy was achieved in 83% of the women. Five patients experience absence of menstrual periods for at least 12 months after the embolization resulting in menopause rate of 42%. Ten patients (83%) reported to be very or fairly satisfied with the results and would recommend this treatment to a friend. Conclusions: Uterine artery embolization might be safe and effective method of treatment for patients with symptomatic adenomyosis with or without fibroids with very high rate of satisfied patients. [ABSTRACT FROM AUTHOR]

This document is a case study published in the journal Ginekologia Polska. It presents the case of a 26-year-old patient with multiple uterine fibroids, one of which was diagnosed as a leiomyosarcoma. The patient underwent surgery to remove the fibroids and experienced a mild postoperative wound infection. The histological diagnosis confirmed the presence of leiomyosarcoma in one tumor and leiomyoma in the remaining five tumors. This case serves as a reminder to maintain oncological vigilance in all patients with uterine tumors. [Extracted from the article]

Objective: To study the timing of the effect of linzagolix, an oral GnRH antagonist, on significant reduction in heavy menstrual bleeding (HMB) in women with uterine fibroids., Design: The study used pooled data from PRIMROSE1 and PRIMROSE2, two double-blind, similar placebo-controlled trials of linzagolix in US and Europe, respectively. Eligible participants were randomized equally across four treatment arms (linzagolix 100mg and 200mg, with and without concomitant hormonal add-back therapy [ABT] consisting of 1 mg estradiol and 0.5 mg norethisterone acetate) and one placebo arm. The cumulative incidence of achieving clinically significant HMB reduction and maintaining it to week 24 was compared between the linzagolix arms and the placebo arm using Kaplan-Meier plots adjusted for confounding by race and study (PRIMROSE1 vs PRIMROSE2)., Subjects: The PRIMROSE trials randomized 1,012 women aged ≥18 years with ultrasound-confirmed uterine fibroids and HMB., Intervention: Linzagolix (100mg and 200mg, with and without hormonal add-back therapy) versus placebo., Main Outcome Measures: The main outcome of this analysis was the time to achievement of clinically significant HMB reduction and its maintenance up to week 24., Results: The onset of action in achieving and maintaining clinically significant HMB reduction was significantly more rapid for the linzagolix treatment arms than for the placebo arm, with a median time of <4 weeks for most linzagolix doses (except 100mg alone). The fastest onset was seen with linzagolix 200mg with or without ABT doses, with a median time of only 3 days. The cumulative incidence of achieving clinically significant HMB reduction by week 4 and maintaining it to week 24 was also significantly higher for the linzagolix treatment arms than the placebo arm. Specifically, across the four linzagolix treatment arms, 23.2% to 68.1% achieved clinically significant HMB reduction by week 4 and maintained it to week 24 versus 7.8% for placebo arm., Conclusion: Linzagolix was associated with a quick effect on reducing clinically significant HMB compared to placebo. Linzagolix thus offers a novel non-invasive treatment approach for the rapid management of HMB symptoms in patients with uterine fibroids., (Copyright © 2025. Published by Elsevier Inc.)

It is estimated that chronic pelvic pain (CPP) may affect up to 24% of women. Unfortunately, very often, despite extensive diagnostics, the cause of CPP remains unknown. The pathophysiology of CPP could be explained to a large extent by the occurrence of pelvic venous disorders (PVD). Although pelvic venography is still considered the gold standard for the diagnosis of PVD, noninvasive diagnostic imaging techniques seem to be instrumental in the initial identification of patients with PVD. This literature review aimed to analyze and evaluate the usefulness of noninvasive diagnostic imaging techniques like transvaginal ultrasonography, transabdominal ultrasonography, magnetic resonance, and computed tomography in the diagnosis and identification of patients with PVD. Forty-one articles published between 1984 and 2023 were included in this literature review. Based on this literature review, we conclude that the clinical application of noninvasive diagnostic techniques in the diagnosis of PVD seems to be very promising. Future studies investigating the role of noninvasive diagnostic imaging techniques in the diagnosis of PVD are required., Competing Interests: The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Adrenocortical carcinoma (ACC) is a malignant tumour that originates from the adrenal cortex. It is a highly aggressive cancer characterised by a poor prognosis with an annual incidence estimated to be up to 2 cases per million. In the adult population, ACC is diagnosed typically between 40 and 50 years of age, more often in women. Complete surgical resection of the tumour is the primary treatment method for ACC. Unfortunately, despite properly performed adrenalectomy, regional recurrences or distant metastases are detected in up to 90% of the patients. For that reason, adjuvant therapy is recommended. Mitotane is the most effective adrenal-specific agent used in adjuvant and palliative therapy. Two menstruating patients, after adrenalectomy due to ACC, during adjuvant mitotane therapy, have been included in the study. The study aimed to assess the effect of mitotane therapy on the endometrium and its clinical consequences, based on the analysis of these two cases and a review of the literature. It seems that menorrhagia may be expected during adjuvant mitotane therapy of ACC in menstruating women. Heavy uterine bleeding during menstruation may appear several months after the beginning of therapy. The likely mechanism for heavy menstrual bleeding is complex. Menorrhagia can occur due to the toxic effect of mitotane in the form of a haemorrhagic diathesis, while long-term treatment (over ten months) can lead to relative hypoestrogenism resulting in endometrial hyperplasia. Clinical signs of hypoestrogenism during mitotane treatment, have been described (including pre-puberty girls) and should be considered as a side-effect of the therapy. Menorrhagia may lead to severe anaemia, so this should be considered when planning mitotane treatment. Continuous gestagen therapy is helpful in the treatment of the above disorders. After over 60 years of experience with mitotane usage, knowledge about it is still insufficient, and further studies are required., Competing Interests: None., (AJCR Copyright © 2024.)