Clinical study of uterine Leiomyoma and its associated risk factors

Abstract

Introduction: Uterine leiomyomas have historically been viewed as major indication for hysterectomy. As new therapies have developed, the heterogeneity of this disease has become therapeutically relevant. An awareness of the role of risk factors, growth factors, hormones and genetics in tumor etiology is the key to understanding of this disease. This study was undertaken to know the various risk factors associated with uterine leiomyoma.

Objective: To Study the clinical features and various risk factors associated with leiomyoma of uterus.

Materials and Methods: This is a hospital based prospective study of 55 uterine leiomyoma cases. After taking consent all cases were enrolled into the study and detailed history regarding mode of presentation, clinical features and various risk factors of uterine leiomyoma was taken, all cases underwent transvaginal ultrasound to know the location of leiomyoma. Specimen of leiomyoma was sent for histopathological examination and analysed.

Results: Mean age group of the cases was between 41 – 50 years. Mean age at menarche was 12.9 years. Maximum numbers of cases were in the group of PARA – 2. Abnormal uterine bleeding like Menorrhagia, Polymenorrhea, Metrorrhagia, and Dysmenorrhea were the most common modes of presentation followed by pain and increased urinary frequency. In the present study 49.09% of subjects were above normal BMI range. Individuals with sedentary life style were at higher risk of developing leiomyoma. Intramural was the commonest location of fibroid followed by subserosal and submucus fibroids. On Histopathological examination, leiomyoma was confirmed and Cervicitis was the most common accompanying feature followed by adenomyoisis and degeneration.

Conclusion: Leiomyoma of uterus is multifactorial in origin with various factors acting in conjunction. Increased oestrogen exposures due to factors modulate myometrial cells and act as tumor promoters. Reproductive age of patient, early menarche, obesity and parity are most common risk fctors which modulate estrogen response.