Urology treats urinary tract diseases in all genders and male reproductive issues, covering the kidneys, bladder, prostate, urethra, from infections to complex cancers.
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The clinical presentation of uterine fibroids is highly variable. Approximately 50% of women are asymptomatic, with the condition discovered incidentally during routine pelvic exams or imaging. For symptomatic women, the manifestations are debilitating and are classified into three primary categories: Abnormal Uterine Bleeding, Bulk/Pressure Symptoms, and Reproductive Dysfunction.
This is the most frequent indication for medical or surgical intervention. In the FIGO classification of bleeding, this is termed AUB-L (Leiomyoma).
Understanding risk factors aids in early detection and lifestyle modification.
As fibroids enlarge, they act as space-occupying lesions within the confined bony pelvis.
Radiculopathy: Huge fibroids can compress the pelvic nerves (obturator or sciatic nerves), causing referred pain radiating to the lower back, buttocks, or legs.
Fibroids are implicated in 2-3% of infertility cases and can complicate pregnancy.
Pain: Red degeneration causes severe localized pain, usually in the second trimester.
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Yes, large fibroids, particularly those located on the posterior aspect of the uterus, can exert pressure on the sacral plexus or the sciatic nerve roots. This compression causes referred pain that radiates to the lower back, glutes, and down the legs, mimicking musculoskeletal sciatica.
Fibroids increase the surface area of the uterine lining, create a chaotic and fragile vascular network (angiogenesis), and physically prevent the uterine muscle fibers from contracting tightly to seal off the spiral arteries at the end of menstruation, resulting in prolonged and heavy flow and the passage of clots.
While a direct causal link remains to be elucidated, epidemiological studies show a significant inverse relationship: women with low Vitamin D levels have a higher prevalence of fibroids. In vitro studies show that Vitamin D inhibits fibroid cell proliferation and ECM deposition, suggesting that deficiency may facilitate tumor growth.
Yes, in two ways. First, large fibroids can weigh several kilograms themselves (some reaching 5-10kg or more), directly adding to body mass. Second, the abdominal distension caused by the tumor (“fibroid belly”) can mimic visceral fat accumulation or pregnancy.
Generally, fibroids cause pain during menstruation (dysmenorrhea) due to uterine cramping. However, large fibroids can cause a constant sensation of pelvic fullness or pressure that may be exacerbated during ovulation or the premenstrual phase due to transient hormonal fluid retention and pelvic congestion.
Robotic hysterectomy is a new way to treat gynecological issues. A big worry for patients is how long it takes to get better. Studies show
Did you know that nearly 600,000 women in the United States undergo hysterectomy every year? This surgery removes the uterus and is a common treatment
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