Surgical versus Non-Surgical Management in Fibroid Uterus: A Prospective Observational Study

Abstract

Background and Aim: Uterine fibroid is the benign condition, known to occur more during reproductive period
of women. It is mainly caused due to increased level of estrogen & progesterone & peptide growth. Current
management strategies mainly involve surgical interventions, but choice of treatment is guided by patient’s age
and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy
Material and Methods: It is the prospective observational study conducted in patients of department of Obstetrics
and Gynecology at tertiary care hospital for the duration of one and half year. The treatment prognosis and
outcome was measured in the symptomatic relief in patients, increase in quality of life, decrease in size of fibroid
present, requirement of blood transfusion, definitive length of stay in the hospital and successful pregnancy after
the line of management.
Results: Of the total 60 patients diagnosed with fibroid uterus, there were 20 patients with fibroid size less
than 8 cm and in 40 patients the size of fibroid was more than or equal to 8 cm. Among the 32 patients treated
with medical line of management, 10 patients were treated with tablet ulipristal acetate 5 mg od for 3 months.
Amongst the 28 patients treated surgically, in 7 patients myomectomy was done, 2 patients underwent vaginal
hysterectomy, in 2 patient’s laparoscopic assisted vaginal hysterectomy done (LAVH) and 17 patients underwent
total abdominal hysterectomy (TAH).
Conclusion: The choice of treatment must be individualized to the women’s need and her clinical presentation.
Medical line of management is best for patients in younger age group, small size fibroid, desire for future fertility.
In medical line of management, ulipristal and mifepristone have better outcomes.