CLINICAL PROFILE AND TREATMENT OUTCOME IN UTERINE FIBROIDS

Abstract

Background: Uterine fibroids are the most common benign tumours of the female reproductive tract and a major cause of gynaecological morbidity among women of reproductive age. They commonly present with abnormal uterine bleeding, anaemia, pelvic pressure symptoms, and infertility, leading to significant impairment in quality of life. Management options include medical therapy, surgical intervention, and newer minimally invasive uterus-preserving techniques. Symptom sever- ity, fibroid characteristics, and fertility desires influence the treatment choice. 

Objective: To assess the clinical profile and treatment outcomes in women with uterine fibroids. 

Materials and Methods: This retrospective observational study was conducted over two years at a tertiary care center in India. A total of 100 women diagnosed with symptomatic uterine fibroids were included and categorized into two groups based on treatment received: medical management (n = 35) and surgical management (n = 65). Clinical presentation, ultrasonographic findings, treatment modalities, symptom relief, fibroid size response, fertility outcomes, and complications were analyzed. Statistical analysis was performed using SPSS version 25.0, with p < 0.05 considered statistically significant. 

Results: The majority of patients were aged 35–55 years (68%). Abnormal uterine bleeding was the most common present- ing symptom (56%), and anaemia was observed in 70% cases. Solitary fibroids were present in 58% of patients, while 42% had multiple fibroids. Medical management was more effective in patients with fibroids <8 cm, with an 88.5% response rate, whereas larger fibroids (≥8 cm) required surgical intervention in 77.8% of cases. Among surgical procedures, total abdominal hysterectomy was the most commonly performed (50.8%), while myomectomy was the preferred fertility-preserving sur- gery. Fertility outcomes were superior following myomectomy, with an 80% pregnancy success rate. Surgical management provided more definitive symptom relief and lower intervention rates compared to medical therapy. 

Conclusion: Medical management offers effective symptom control in selected patients with small, solitary fibroids and fertility-preservation goals. However, surgical management remains the definitive treatment for women with large or multiple fibroids, severe symptoms, or failed medical therapy. An individualized, patient-centered approach is essential to optimize clinical outcomes in women with uterine fibroids.