An update on the management of uterine fibroids

ABSTRACT

Uterine fibroids are common especially in women of African ancestry. When they are symptomatic they need to be treated. Treatment with medical therapy alone, such as gonadotropin-releasing hormone (GnRH) agonists, has been disappointing. Hysterectomy is recommended in women who have completed their family. Myomectomy is done in women who wish to conserve their uterus, this can be done in some women by laparoscopy or by hysteroscopy. Most women with large fibroids still require laparotomy. Intraoperative haemorrhage is, however, still a major concern. Pretreatment with GnRH agonists and intraoperative perivascular vasopressin injections are new methods, which have been shown to be valuable in reducing the impact of this complication (AU)