SlideShare a Scribd company logo

leiomyomas

•Download as PPT, PDF•
•
Karl Daniel, M.D.
Karl Daniel, M.D.

The document summarizes guidelines for the management of uterine leiomyomas (fibroids). It discusses various treatment options including medical management with drugs like GnRH agonists, and surgical options like hysterectomy, myomectomy (surgical removal of fibroids), and newer minimally invasive options like uterine artery embolization and laparoscopic myolysis (coagulation of fibroids). It provides details on the risks, benefits, and evidence for each approach and notes that treatment should be individualized based on a woman's symptoms and desire for fertility.

1 of 158
THE MANAGEMENT OF UTERINE LEIOMYOMAS Dr .Ashraf Fouda Egypt - Damietta General Hospital E. mail : ashraffoda@hotmail.com
S.O.G.C. ( S ociety of O bstetricians & G ynecologists of C anada) CLINICAL PRACTICE GUIDELINES SOURCE: May 2003
 
[object Object]
[object Object],[object Object]
[object Object]
[object Object]
INTRODUCTION ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],INTRODUCTION
[object Object],INTRODUCTION
[object Object],INTRODUCTION
CLINICAL FEATURES ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],CLINICAL FEATURES
[object Object],[object Object],[object Object],[object Object],[object Object],CLINICAL FEATURES
[object Object],CLINICAL FEATURES
[object Object],CLINICAL FEATURES
EVALUATION ,[object Object]
[object Object],EVALUATION
[object Object],EVALUATION
[object Object],[object Object],EVALUATION
[object Object],EVALUATION
MEDICAL MANAGEMENT ,[object Object]
[object Object],MEDICAL MANAGEMENT
[object Object],MEDICAL MANAGEMENT
[object Object],[object Object],(GnRH) agonists
[object Object],MEDICAL MANAGEMENT
[object Object],[object Object],MEDICAL MANAGEMENT
[object Object],[object Object],MEDICAL MANAGEMENT
SURGICAL MANAGEMENT
HYSTERECTOMY ,[object Object],[object Object],[object Object]
[object Object],HYSTERECTOMY
[object Object],HYSTERECTOMY
[object Object],HYSTERECTOMY
[object Object],[object Object],HYSTERECTOMY
[object Object],HYSTERECTOMY
[object Object],HYSTERECTOMY
CONSERVATIVE SURGICAL THERAPIES
[object Object],[object Object],[object Object],MYOMECTOMY THROUGH A LAPAROTOMY INCISION
[object Object],[object Object],[object Object],MYOMECTOMY THROUGH A LAPAROTOMY INCISION
[object Object],[object Object],MYOMECTOMY THROUGH A LAPAROTOMY INCISION
LAPAROSCOPIC MYOMECTOMY ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],[object Object],[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
[object Object],[object Object],LAPAROSCOPIC MYOMECTOMY
HYSTEROSCOPIC MYOMECTOMY ,[object Object]
[object Object],[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],[object Object],[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],[object Object],HYSTEROSCOPIC MYOMECTOMY
[object Object],HYSTEROSCOPIC MYOMECTOMY
LAPAROSCOPIC MYOLYSIS ,[object Object]
[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],[object Object],[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
[object Object],[object Object],LAPAROSCOPIC MYOLYSIS
SELECTIVE UTERINE ARTERY OCCLUSION ,[object Object]
[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
[object Object],[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
[object Object],[object Object],[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
[object Object],[object Object],SELECTIVE UTERINE ARTERY OCCLUSION
PERIOPERATIVE RISKS AND COMPLICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POST–UTERINE ARTERY OCCLUSION SIDE EFFECTS AND COMPLICATIONS
[object Object],Early or Acute Abdominal Pelvic Pain
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Early or Acute Abdominal Pelvic Pain
[object Object],Early or Acute Abdominal Pelvic Pain
Post embolization Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Post embolization Syndrome
Infection ,[object Object],[object Object],[object Object]
[object Object],Infection
[object Object],Infection
Persistent or Chronic Pain ,[object Object],[object Object],[object Object]
Ovarian Dysfunction ,[object Object]
[object Object],[object Object],Ovarian Dysfunction
Menstrual Dysfunction ,[object Object]
[object Object],[object Object],Menstrual Dysfunction
Transcervical Myoma Expulsion ,[object Object],[object Object]
Uterine Wall Integrity ,[object Object],[object Object]
[object Object],Uterine Wall Integrity
Hysterectomy ,[object Object]
[object Object],Hysterectomy
Mortality ,[object Object],[object Object]
[object Object],[object Object],Mortality
SPECIAL CONSIDERATIONS
FIBROIDS AND INFERTILITY ,[object Object],[object Object]
[object Object],FIBROIDS AND INFERTILITY
[object Object],[object Object],FIBROIDS AND INFERTILITY
[object Object],FIBROIDS AND INFERTILITY
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FIBROIDS AND INFERTILITY
[object Object],[object Object],FIBROIDS AND INFERTILITY
FIBROIDS AND PREGNANCY ,[object Object],[object Object]
[object Object],[object Object],FIBROIDS AND PREGNANCY
[object Object],[object Object],[object Object],[object Object],FIBROIDS AND PREGNANCY
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FIBROIDS AND PREGNANCY
[object Object],[object Object],[object Object],[object Object],FIBROIDS AND PREGNANCY
[object Object],[object Object],[object Object],[object Object],[object Object],FIBROIDS AND PREGNANCY
[object Object],FIBROIDS AND PREGNANCY
[object Object],[object Object],FIBROIDS AND PREGNANCY
ACUTE BLEEDING ,[object Object]
[object Object],[object Object],ACUTE BLEEDING
[object Object],ACUTE BLEEDING
[object Object],ACUTE BLEEDING
[object Object],[object Object],ACUTE BLEEDING
FIBROIDS IN MENOPAUSE ,[object Object]
[object Object],[object Object],Effect of HRT on fibroids in postmenopausal women.
FIBROIDS AND UTERINE LEIOMYOSARCOMAS ,[object Object],[object Object]
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
[object Object],FIBROIDS AND UTERINE LEIOMYOSARCOMAS
Recommendations: ,[object Object],[object Object],(III-C)
[object Object],Recommendations (II-A)
[object Object],Recommendations (II-B)
[object Object],Recommendations (II-B)
[object Object],Recommendations (I-B)
[object Object],Recommendations: (II-B)
[object Object],Recommendations: (I-C)
[object Object],[object Object],[object Object],Recommendations: (III-C)
[object Object],Recommendations: (III-C)
[object Object],Recommendations: (III-C)
[object Object],Recommendations: (III-C)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Recommendations: (III-C)
[object Object],[object Object],Recommendations: (II-B)
[object Object],Recommendations: (III-C)
CONCLUSION ,[object Object],[object Object]
[object Object],CONCLUSION
[object Object],CONCLUSION
Thank you

Recommended

Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgargLaparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Pradeep Garg
 
postpartum collapse
postpartum collapse postpartum collapse
postpartum collapse
tariggally
 
Vulval ca and vulval lymph
Vulval ca and vulval lymphVulval ca and vulval lymph
Vulval ca and vulval lymph
hemnathsubedii
 
Tubal factor infertility
Tubal factor infertilityTubal factor infertility
Tubal factor infertility
Aboubakr Elnashar
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
Garima Prakash
 
Hysteroscopic metroplasty
Hysteroscopic metroplasty Hysteroscopic metroplasty
Hysteroscopic metroplasty Hesham Gaber
 
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIMANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
DR SHASHWAT JANI
 
Radical hysterectomy
Radical hysterectomyRadical hysterectomy
Radical hysterectomy
hemnathsubedii
 

Recommended

Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgargLaparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Laparoscopic Tubal Recanalization Mob: 7289915430, www.drpradeepgarg
Pradeep Garg
 
postpartum collapse
postpartum collapse postpartum collapse
postpartum collapse
tariggally
 
Vulval ca and vulval lymph
Vulval ca and vulval lymphVulval ca and vulval lymph
Vulval ca and vulval lymph
hemnathsubedii
 
Tubal factor infertility
Tubal factor infertilityTubal factor infertility
Tubal factor infertility
Aboubakr Elnashar
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
Garima Prakash
 
Hysteroscopic metroplasty
Hysteroscopic metroplasty Hysteroscopic metroplasty
Hysteroscopic metroplasty Hesham Gaber
 
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIMANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
DR SHASHWAT JANI
 
Radical hysterectomy
Radical hysterectomyRadical hysterectomy
Radical hysterectomy
hemnathsubedii
 
Post menopausal bleeding
Post menopausal bleedingPost menopausal bleeding
Post menopausal bleeding
dr.hafsa asim
 
Medical Management of Fibroids
Medical Management of FibroidsMedical Management of Fibroids
Medical Management of Fibroids
Sujoy Dasgupta
 
Hysteroscopy
HysteroscopyHysteroscopy
HysteroscopyGururaj Deshpande
 
Prophylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancerProphylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancer
muhammad al hennawy
 
Pelvic mass panel discussion
Pelvic mass panel discussionPelvic mass panel discussion
Pelvic mass panel discussion
Niranjan Chavan
 
gestational trophoblastic disease GTD
gestational trophoblastic disease GTDgestational trophoblastic disease GTD
gestational trophoblastic disease GTDOsama Warda
 
Postmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduatePostmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduate
Faculty of Medicine,Zagazig University,EGYPT
 
Mullerian anomalies
Mullerian anomaliesMullerian anomalies
Mullerian anomalies
drmcbansal
 
Salpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionSalpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reduction
muhammad al hennawy
 
Non descent vaginal hysterectomy
Non descent vaginal hysterectomyNon descent vaginal hysterectomy
Non descent vaginal hysterectomyRajni Singh
 
Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology) Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology)
D.A.B.M
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligation
SnehaRonge
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
Osama Warda
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
dr.hafsa asim
 
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
Lifecare Centre
 
Uma mogs2015result
Uma mogs2015resultUma mogs2015result
Uma mogs2015result
uma tripathi
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
Drpawan Jhalta
 
Pelvic organ prolapse
Pelvic organ prolapsePelvic organ prolapse
Pelvic organ prolapse
Aloy Okechukwu Ugwu
 
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
Pradeep Garg
 
Endometrial Hyperplasia
Endometrial HyperplasiaEndometrial Hyperplasia
Endometrial Hyperplasiatareq chowdhury
 
Leiomyoma
LeiomyomaLeiomyoma
LeiomyomaClinton Pong
 
Production & operation mgt
Production & operation mgtProduction & operation mgt
Production & operation mgtkitturashmikittu
 

More Related Content

What's hot

Post menopausal bleeding
Post menopausal bleedingPost menopausal bleeding
Post menopausal bleeding
dr.hafsa asim
 
Medical Management of Fibroids
Medical Management of FibroidsMedical Management of Fibroids
Medical Management of Fibroids
Sujoy Dasgupta
 
Prophylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancerProphylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancer
muhammad al hennawy
 
Pelvic mass panel discussion
Pelvic mass panel discussionPelvic mass panel discussion
Pelvic mass panel discussion
Niranjan Chavan
 
gestational trophoblastic disease GTD
gestational trophoblastic disease GTDgestational trophoblastic disease GTD
gestational trophoblastic disease GTDOsama Warda
 
Postmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduatePostmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduate
Faculty of Medicine,Zagazig University,EGYPT
 
Mullerian anomalies
Mullerian anomaliesMullerian anomalies
Mullerian anomalies
drmcbansal
 
Salpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionSalpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reduction
muhammad al hennawy
 
Non descent vaginal hysterectomy
Non descent vaginal hysterectomyNon descent vaginal hysterectomy
Non descent vaginal hysterectomyRajni Singh
 
Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology) Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology)
D.A.B.M
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligation
SnehaRonge
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
Osama Warda
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
dr.hafsa asim
 
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
Lifecare Centre
 
Uma mogs2015result
Uma mogs2015resultUma mogs2015result
Uma mogs2015result
uma tripathi
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
Drpawan Jhalta
 
Pelvic organ prolapse
Pelvic organ prolapsePelvic organ prolapse
Pelvic organ prolapse
Aloy Okechukwu Ugwu
 
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
Pradeep Garg
 

What's hot (20)

Post menopausal bleeding
Post menopausal bleedingPost menopausal bleeding
Post menopausal bleeding
 
Medical Management of Fibroids
Medical Management of FibroidsMedical Management of Fibroids
Medical Management of Fibroids
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
 
Prophylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancerProphylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancer
 
Pelvic mass panel discussion
Pelvic mass panel discussionPelvic mass panel discussion
Pelvic mass panel discussion
 
gestational trophoblastic disease GTD
gestational trophoblastic disease GTDgestational trophoblastic disease GTD
gestational trophoblastic disease GTD
 
Postmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduatePostmenopausal bleeding for undergraduate
Postmenopausal bleeding for undergraduate
 
Mullerian anomalies
Mullerian anomaliesMullerian anomalies
Mullerian anomalies
 
Salpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionSalpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reduction
 
Non descent vaginal hysterectomy
Non descent vaginal hysterectomyNon descent vaginal hysterectomy
Non descent vaginal hysterectomy
 
Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology) Uterus Transplantation Utx (obstetric and gynecology)
Uterus Transplantation Utx (obstetric and gynecology)
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligation
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
 
Endometrial hyperplasia
Endometrial hyperplasiaEndometrial hyperplasia
Endometrial hyperplasia
 
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
PUBERTY MENORRHAGIA & BLEEDING DISORDERS Made Easy Dr Sharda Jain
 
Uma mogs2015result
Uma mogs2015resultUma mogs2015result
Uma mogs2015result
 
Hysteroscopy
HysteroscopyHysteroscopy
Hysteroscopy
 
Pelvic organ prolapse
Pelvic organ prolapsePelvic organ prolapse
Pelvic organ prolapse
 
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
 
Endometrial Hyperplasia
Endometrial HyperplasiaEndometrial Hyperplasia
Endometrial Hyperplasia
 

Viewers also liked

Production & operation mgt
Production & operation mgtProduction & operation mgt
Production & operation mgtkitturashmikittu
 
The RIGHT Way to Approach Long-Term Care Insurance
The RIGHT Way to Approach Long-Term Care InsuranceThe RIGHT Way to Approach Long-Term Care Insurance
The RIGHT Way to Approach Long-Term Care InsuranceDavidK051
 
Superstitions
SuperstitionsSuperstitions
Superstitions
clover66
 
alternatives to hysterectomy
alternatives to hysterectomyalternatives to hysterectomy
alternatives to hysterectomyKarl Daniel, M.D.
 
How do I get the most value out of my technology investments?
How do I get the most value out of my technology investments?How do I get the most value out of my technology investments?
How do I get the most value out of my technology investments?
Anupam Kundu
 
Datidalle cose digitalfestival2013
Datidalle cose digitalfestival2013Datidalle cose digitalfestival2013
Datidalle cose digitalfestival2013
CSP Scarl
 
Bideoa eta hezkuntza
Bideoa eta hezkuntzaBideoa eta hezkuntza
Bideoa eta hezkuntza
patricia
 
What is Lean Startup?
What is Lean Startup?What is Lean Startup?
What is Lean Startup?
Chris Shayan
 
Svea elearning2.ppt
Svea elearning2.pptSvea elearning2.ppt
Svea elearning2.pptCSP Scarl
 
Presentation1
Presentation1Presentation1
Presentation1denapaden
 
Storie dal futuro: persone e cose sempre connesse
Storie dal futuro: persone e cose sempre connesseStorie dal futuro: persone e cose sempre connesse
Storie dal futuro: persone e cose sempre connesse
CSP Scarl
 
Langrich社でのEmacs活用、langrich.el
Langrich社でのEmacs活用、langrich.elLangrich社でのEmacs活用、langrich.el
Langrich社でのEmacs活用、langrich.el
Takashi Masuda
 
Small group presentation
Small group presentationSmall group presentation
Small group presentationVOX Church
 
Forum PA challenge: HALADIN's
Forum PA challenge: HALADIN'sForum PA challenge: HALADIN's
Forum PA challenge: HALADIN's
CSP Scarl
 
Calendario
CalendarioCalendario
Calendario
InstitutoCalidad
 
Il catalogo 2010 Asset CSP
Il catalogo 2010 Asset CSP Il catalogo 2010 Asset CSP
Il catalogo 2010 Asset CSP
CSP Scarl
 

Viewers also liked (20)

Leiomyoma
LeiomyomaLeiomyoma
Leiomyoma
 
Production & operation mgt
Production & operation mgtProduction & operation mgt
Production & operation mgt
 
The RIGHT Way to Approach Long-Term Care Insurance
The RIGHT Way to Approach Long-Term Care InsuranceThe RIGHT Way to Approach Long-Term Care Insurance
The RIGHT Way to Approach Long-Term Care Insurance
 
Superstitions
SuperstitionsSuperstitions
Superstitions
 
Rajeev_CV
Rajeev_CVRajeev_CV
Rajeev_CV
 
alternatives to hysterectomy
alternatives to hysterectomyalternatives to hysterectomy
alternatives to hysterectomy
 
How do I get the most value out of my technology investments?
How do I get the most value out of my technology investments?How do I get the most value out of my technology investments?
How do I get the most value out of my technology investments?
 
Datidalle cose digitalfestival2013
Datidalle cose digitalfestival2013Datidalle cose digitalfestival2013
Datidalle cose digitalfestival2013
 
Bideoa eta hezkuntza
Bideoa eta hezkuntzaBideoa eta hezkuntza
Bideoa eta hezkuntza
 
amenorrhea
amenorrheaamenorrhea
amenorrhea
 
What is Lean Startup?
What is Lean Startup?What is Lean Startup?
What is Lean Startup?
 
Svea elearning2.ppt
Svea elearning2.pptSvea elearning2.ppt
Svea elearning2.ppt
 
Horse trail1
Horse trail1Horse trail1
Horse trail1
 
Presentation1
Presentation1Presentation1
Presentation1
 
Storie dal futuro: persone e cose sempre connesse
Storie dal futuro: persone e cose sempre connesseStorie dal futuro: persone e cose sempre connesse
Storie dal futuro: persone e cose sempre connesse
 
Langrich社でのEmacs活用、langrich.el
Langrich社でのEmacs活用、langrich.elLangrich社でのEmacs活用、langrich.el
Langrich社でのEmacs活用、langrich.el
 
Small group presentation
Small group presentationSmall group presentation
Small group presentation
 
Forum PA challenge: HALADIN's
Forum PA challenge: HALADIN'sForum PA challenge: HALADIN's
Forum PA challenge: HALADIN's
 
Calendario
CalendarioCalendario
Calendario
 
Il catalogo 2010 Asset CSP
Il catalogo 2010 Asset CSP Il catalogo 2010 Asset CSP
Il catalogo 2010 Asset CSP
 

Similar to leiomyomas

Endometrial hyperplasia dr.alajami
Endometrial hyperplasia dr.alajamiEndometrial hyperplasia dr.alajami
Endometrial hyperplasia dr.alajami
’Mohamed Alajami
 
Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Magda Helmi
 
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
Amer Raza
 
Uterine fibroid
Uterine fibroidUterine fibroid
Uterine fibroid
azza mokhtar
 
When more is not better: The 10 ‘Don’ts’ in Endometriosis Management
When more is not better: The 10 ‘Don’ts’ in Endometriosis ManagementWhen more is not better: The 10 ‘Don’ts’ in Endometriosis Management
When more is not better: The 10 ‘Don’ts’ in Endometriosis Management
Ahmed Al Amely
 
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
Lifecare Centre
 
Hysteroscopic endometial resection
Hysteroscopic endometial resectionHysteroscopic endometial resection
Hysteroscopic endometial resection
Dr. Aisha M Elbareg
 
Hysteroscopic endometial resection
Hysteroscopic endometial resectionHysteroscopic endometial resection
Hysteroscopic endometial resection
Dr. Aisha M Elbareg
 
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
ijtsrd
 
Case Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagiaCase Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagia
Lyndon Woytuck
 
Laparoscopic Ovarian Surgery
Laparoscopic Ovarian SurgeryLaparoscopic Ovarian Surgery
Laparoscopic Ovarian Surgery
World Laparoscopy Hospital
 
Uterine leiomyoma (fibroid)
Uterine leiomyoma (fibroid)Uterine leiomyoma (fibroid)
Uterine leiomyoma (fibroid)
Sara Al-Ghanem
 
Carcinoma of endometrium
Carcinoma of endometriumCarcinoma of endometrium
Carcinoma of endometriumraj kumar
 
Laparoscopy for ovarian tumours in in pregnancy
Laparoscopy for ovarian tumours in in pregnancy Laparoscopy for ovarian tumours in in pregnancy
Laparoscopy for ovarian tumours in in pregnancy
Niranjan Chavan
 
Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasiaAhmad Saber
 
AUB in reproductive age group women
AUB in reproductive age group womenAUB in reproductive age group women
AUB in reproductive age group women
seema nishad
 
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
Aboubakr Elnashar
 

Similar to leiomyomas (20)

Leiomyomata uteri
Leiomyomata uteriLeiomyomata uteri
Leiomyomata uteri
 
Endometrial hyperplasia dr.alajami
Endometrial hyperplasia dr.alajamiEndometrial hyperplasia dr.alajami
Endometrial hyperplasia dr.alajami
 
Myoma Uteri
Myoma UteriMyoma Uteri
Myoma Uteri
 
Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1
 
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
The Obstetric Gynaecologis - 2018 - Bryant‐Smith - Laparoscopic myomectomy ...
 
Uterine fibroid
Uterine fibroidUterine fibroid
Uterine fibroid
 
When more is not better: The 10 ‘Don’ts’ in Endometriosis Management
When more is not better: The 10 ‘Don’ts’ in Endometriosis ManagementWhen more is not better: The 10 ‘Don’ts’ in Endometriosis Management
When more is not better: The 10 ‘Don’ts’ in Endometriosis Management
 
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
Great Tips of Managing FIBROIDS with INFERTILITY, Dr. Sharda Jain
 
Hysteroscopic endometial resection
Hysteroscopic endometial resectionHysteroscopic endometial resection
Hysteroscopic endometial resection
 
Hysteroscopic endometial resection
Hysteroscopic endometial resectionHysteroscopic endometial resection
Hysteroscopic endometial resection
 
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...
 
Case Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagiaCase Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagia
 
Laparoscopic Ovarian Surgery
Laparoscopic Ovarian SurgeryLaparoscopic Ovarian Surgery
Laparoscopic Ovarian Surgery
 
Uterine leiomyoma (fibroid)
Uterine leiomyoma (fibroid)Uterine leiomyoma (fibroid)
Uterine leiomyoma (fibroid)
 
Pyometra
PyometraPyometra
Pyometra
 
Carcinoma of endometrium
Carcinoma of endometriumCarcinoma of endometrium
Carcinoma of endometrium
 
Laparoscopy for ovarian tumours in in pregnancy
Laparoscopy for ovarian tumours in in pregnancy Laparoscopy for ovarian tumours in in pregnancy
Laparoscopy for ovarian tumours in in pregnancy
 
Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasia
 
AUB in reproductive age group women
AUB in reproductive age group womenAUB in reproductive age group women
AUB in reproductive age group women
 
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
The Management of Uterine Fibroids in Women With Otherwise Unexplained Infer...
 

More from Karl Daniel, M.D.

Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted InfectionsKarl Daniel, M.D.
 
Screening for Female Genital Tract Malignancy
Screening for Female Genital Tract MalignancyScreening for Female Genital Tract Malignancy
Screening for Female Genital Tract MalignancyKarl Daniel, M.D.
 
Contemporary Use of the Pessary
Contemporary Use of the PessaryContemporary Use of the Pessary
Contemporary Use of the PessaryKarl Daniel, M.D.
 
management of cancer of cervix
management of cancer of cervixmanagement of cancer of cervix
management of cancer of cervixKarl Daniel, M.D.
 
HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2Karl Daniel, M.D.
 
HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY Karl Daniel, M.D.
 

More from Karl Daniel, M.D. (20)

menstrual cycle
menstrual cyclemenstrual cycle
menstrual cycle
 
vulvo vaginal infection
vulvo vaginal infectionvulvo vaginal infection
vulvo vaginal infection
 
vesicular molle 2
vesicular molle 2vesicular molle 2
vesicular molle 2
 
vesicular molle 1
vesicular molle 1vesicular molle 1
vesicular molle 1
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
Screening for Female Genital Tract Malignancy
Screening for Female Genital Tract MalignancyScreening for Female Genital Tract Malignancy
Screening for Female Genital Tract Malignancy
 
vaginal prolapse
vaginal prolapsevaginal prolapse
vaginal prolapse
 
prevention Cervical cancer
prevention Cervical cancerprevention Cervical cancer
prevention Cervical cancer
 
ovarian tumor
ovarian tumorovarian tumor
ovarian tumor
 
Contemporary Use of the Pessary
Contemporary Use of the PessaryContemporary Use of the Pessary
Contemporary Use of the Pessary
 
management of cancer of cervix
management of cancer of cervixmanagement of cancer of cervix
management of cancer of cervix
 
fibroids
fibroidsfibroids
fibroids
 
endometriosis
endometriosisendometriosis
endometriosis
 
DnC
DnCDnC
DnC
 
carcinoma vulva
carcinoma vulvacarcinoma vulva
carcinoma vulva
 
adenomyosis
adenomyosisadenomyosis
adenomyosis
 
Evidence Based Diagnosis
Evidence Based DiagnosisEvidence Based Diagnosis
Evidence Based Diagnosis
 
HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2
 
HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY
 
menopause
menopausemenopause
menopause
 

leiomyomas

  • 1. THE MANAGEMENT OF UTERINE LEIOMYOMAS Dr .Ashraf Fouda Egypt - Damietta General Hospital E. mail : ashraffoda@hotmail.com
  • 2. S.O.G.C. ( S ociety of O bstetricians & G ynecologists of C anada) CLINICAL PRACTICE GUIDELINES SOURCE: May 2003
  • 3.  
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.
  • 69.
  • 70.
  • 71.
  • 72.
  • 73.
  • 74.
  • 75.
  • 76.
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83. POST–UTERINE ARTERY OCCLUSION SIDE EFFECTS AND COMPLICATIONS
  • 84.
  • 85.
  • 86.
  • 87.
  • 88.
  • 89.
  • 90.
  • 91.
  • 92.
  • 93.
  • 94.
  • 95.
  • 96.
  • 97.
  • 98.
  • 99.
  • 100.
  • 101.
  • 102.
  • 103.
  • 105.
  • 106.
  • 107.
  • 108.
  • 109.
  • 110.
  • 111.
  • 112.
  • 113.
  • 114.
  • 115.
  • 116.
  • 117.
  • 118.
  • 119.
  • 120.
  • 121.
  • 122.
  • 123.
  • 124.
  • 125.
  • 126.
  • 127.
  • 128.
  • 129.
  • 130.
  • 131.
  • 132.
  • 133.
  • 134.
  • 135.
  • 136.
  • 137.
  • 138.
  • 139.
  • 140.
  • 141.
  • 142.
  • 143.
  • 144.
  • 145.
  • 146.
  • 147.
  • 148.
  • 149.
  • 150.
  • 151.
  • 152.
  • 153.
  • 154.
  • 155.
  • 156.
  • 157.