Uterine fibroid delivered through the cervix: diagnostic and therapeutic management about 23 cases collected at Yopougon teaching hospital, Abidjan, Côte d’Ivoire

Koffi Abdoul Koffi, Kacou Edèle Aka, Ana Toure-Ecra, A. Brou, Arnold Gomez Zoua, N. Olou
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Abstract

Uterine leiomyomas or fibromyomas, more commonly known as fibroid are the most common tumours of the female reproductive tract. Sometimes a submucosal leiomyoma may become pedunculated and progressively externalize from the uterine cavity, causing increased uterine irritability, metrorrhagia and anaemia, pelvic pain and heaviness, and perception of a vaginal mass. Prevalence of this clinical form is rare. We report our experience of taking a series of twenty-three patients, which objectives was contributed to improvement of management of uterine fibroids. We reported our observation in the epidemiological, clinical and therapeutic aspects of cervical delivered forms. It took place from November 2017 to November 2021. These were housewives with an average age of 41.30 years (27-56 years). 63.61% of whom were over 40 years old, the majority of whom were pauciparous (45.46%) with an average parity of 2.91. Nulliparous women accounted for 18.18% of the total. The average duration of the disease was 7.56 months and could reach 48 months. The reason for consultation was dominated by anaemia with 77.27%. The fibroids varied in size (mean 7 cm) and sometimes exceeded 15 cm. Transfusion of concentrated red blood cells was almost constant (88.24%). Surgical treatment was myomectomy by twisting with 53.33% followed by hysterectomy in 26.67%. Management of fibroma delivered through the cervix were anemia frequently requiring a prior blood transfusion. Treatment remains surgery. Informing and educating patients about early consultation would improve the morbidity associated with this condition.
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子宫肌瘤经宫颈娩出:科特迪瓦阿比让约普贡教学医院收集的 23 个病例的诊断和治疗方法
子宫肌瘤或纤维肌瘤,俗称子宫肌瘤,是女性生殖道最常见的肿瘤。有时,粘膜下的子宫肌瘤会形成蒂,并逐渐从子宫腔外移,导致子宫刺激性增加、月经过多和贫血、盆腔疼痛和沉重感以及阴道肿块感。这种临床表现很少见。我们报告了对 23 名患者进行系列治疗的经验,其目的是改善子宫肌瘤的治疗。我们报告了对宫颈分娩形式的流行病学、临床和治疗方面的观察。观察时间为 2017 年 11 月至 2021 年 11 月。这些患者均为家庭主妇,平均年龄为 41.30 岁(27-56 岁)。其中 63.61% 的妇女年龄在 40 岁以上,大多数为晚育(45.46%),平均奇偶数为 2.91。单胎妇女占总数的 18.18%。平均病程为 7.56 个月,最长可达 48 个月。就诊原因以贫血为主,占 77.27%。肌瘤大小不一(平均 7 厘米),有时超过 15 厘米。输注浓缩红细胞的比例几乎为88.24%。53.33%的患者接受了肌瘤捻转切除术,26.67%的患者接受了子宫切除术。通过子宫颈娩出的纤维瘤会导致贫血,经常需要事先输血。治疗方法仍然是手术。对患者进行早期诊治的宣传和教育将提高这种疾病的发病率。
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