Tratamiento médico de los miomas uterinos. Del presente al futuro

Abstract

The goal of treating fibroids is symptom control, reversing anaemia (if present), and restoring quality of life. In the event of future reproductive desire, the objective is also to achieve anatomical restoration of the uterus, fundamentally with regard to the uterine cavity.

Prophylactic treatment to prevent future complications of fibroids is not recommended with a few exceptions, such as women with hysteroscopically resectable submucosal fibroids who wish to become pregnant or women with large fibroid uteri with lateral extension causing ureteral compression and moderate or severe hydronephrosis.

There is a broad consensus that the approach to this pathology should be patient-centred, with shared decision-making based on adequate information, meeting the short and long-term objectives of the woman. The information offered must cover all possible options and the risk/benefit balance of each. All the available options have proven efficacy, but we do not have quality studies comparing the options.

Presently available medical treatment options and emerging options are discussed in this article.