Skip to main content
Erschienen in: Current Obstetrics and Gynecology Reports 2/2016

28.03.2016 | Uterine Fibroids (N Narvekar, Section Editor)

Management of Urinary Symptoms Associated with Fibroids

verfasst von: Christos Kleanthis, Martino Zacchè, Ilias Giarenis

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Uterine fibroids are the most common benign tumours in women of reproductive age. Fibroids are linked with a variety of lower urinary tract symptoms (LUTS). Direct pressure on the bladder, but also vascular, neurogenic and hormonal changes have been proposed as underlying pathophysiological mechanisms. There is conflicting evidence in the literature regarding the association between LUTS and fibroid volume and position. Conservative management with bladder retraining, supervised pelvic floor muscle training with or without drug therapy might be used as first line. In the presence of persistent symptoms, conventional urodynamics or ideally videourodynamics might be considered before more invasive treatment. Counselling of patients prior to uterine artery embolisation, myomectomy or hysterectomy could be challenging, as it is difficult to estimate the effect of fibroid reduction or removal on LUTS.
Literatur
3.
Zurück zum Zitat Wallach EE, Vlahos NF. Uterine myomas: an overview of development. Clinical features, and management. Obstet Gynecol. 2004;104:393–406.CrossRefPubMed Wallach EE, Vlahos NF. Uterine myomas: an overview of development. Clinical features, and management. Obstet Gynecol. 2004;104:393–406.CrossRefPubMed
4.
Zurück zum Zitat Doherty L, Mutlu L, Sinclair D, Taylor H. Uterine fibroids: clinical manifestations and contemporary management. Reprod Sci. 2004;21:1067–92.CrossRef Doherty L, Mutlu L, Sinclair D, Taylor H. Uterine fibroids: clinical manifestations and contemporary management. Reprod Sci. 2004;21:1067–92.CrossRef
5.
Zurück zum Zitat Hannestad YS, Rortveit G, Sandvik H, Hunskaar S, Norwegian EPINCONT study, Epidemiology of Incontinence in the County of Nord-Trøndelag. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of incontinence in the county of Nord-Trondelag. J Clin Epidemiol. 2000;53:1150–7.CrossRefPubMed Hannestad YS, Rortveit G, Sandvik H, Hunskaar S, Norwegian EPINCONT study, Epidemiology of Incontinence in the County of Nord-Trøndelag. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of incontinence in the county of Nord-Trondelag. J Clin Epidemiol. 2000;53:1150–7.CrossRefPubMed
6.
Zurück zum Zitat Volkers NA, Hehenkamp WJ, Birnie E, Ankum WM, Reekers JA. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years’ outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2007;196:519.e1–11.CrossRef Volkers NA, Hehenkamp WJ, Birnie E, Ankum WM, Reekers JA. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years’ outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2007;196:519.e1–11.CrossRef
7.
Zurück zum Zitat Ekin M, Cengiz H, Öztürk E, Kaya C, Yasar L, Savan K. Genitourinary symptoms and their effects on quality of life in women with uterine myomas. Int Urogynecol J. 2014;25:807–10.CrossRefPubMed Ekin M, Cengiz H, Öztürk E, Kaya C, Yasar L, Savan K. Genitourinary symptoms and their effects on quality of life in women with uterine myomas. Int Urogynecol J. 2014;25:807–10.CrossRefPubMed
8.
Zurück zum Zitat Dragomir AD, Schroeder JC, Connolly A, Kupper LL, Cousins DS, Olshan AF, et al. Uterine leiomyomata associated with self-reported stress urinary incontinence. J Womens Health (Larchmt). 2010;19:245–50.CrossRef Dragomir AD, Schroeder JC, Connolly A, Kupper LL, Cousins DS, Olshan AF, et al. Uterine leiomyomata associated with self-reported stress urinary incontinence. J Womens Health (Larchmt). 2010;19:245–50.CrossRef
9.
Zurück zum Zitat Alyeshmerni D, Banovac F, Pehlivanova M, McCullough M, Hansford B, Spies J. Resolution of hydronephrosis after uterine artery embolization for fibroids. J Vasc Interv Radiol. 2011;22:865–9.CrossRefPubMed Alyeshmerni D, Banovac F, Pehlivanova M, McCullough M, Hansford B, Spies J. Resolution of hydronephrosis after uterine artery embolization for fibroids. J Vasc Interv Radiol. 2011;22:865–9.CrossRefPubMed
10.
Zurück zum Zitat Wu CQ, Lefebvre G, Frecker H, Husslein H. Urinary retention and uterine leiomyomas: a case series and systematic review of the literature. Int Urogynecol J. 2015;26:1277–84.CrossRefPubMed Wu CQ, Lefebvre G, Frecker H, Husslein H. Urinary retention and uterine leiomyomas: a case series and systematic review of the literature. Int Urogynecol J. 2015;26:1277–84.CrossRefPubMed
11.
Zurück zum Zitat Chauleur C, Vulliez L, Seffert P. Acute urine retention in early pregnancy resulting from fibroid incarceration: proposition for management. Fertil Steril. 2008;90:1198.e7–10.CrossRef Chauleur C, Vulliez L, Seffert P. Acute urine retention in early pregnancy resulting from fibroid incarceration: proposition for management. Fertil Steril. 2008;90:1198.e7–10.CrossRef
12.
Zurück zum Zitat Arleo EK, Tal MG. Fibroid-induced acute urinary retention: treatment by uterine artery embolization. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:161–5.CrossRefPubMed Arleo EK, Tal MG. Fibroid-induced acute urinary retention: treatment by uterine artery embolization. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:161–5.CrossRefPubMed
13.
Zurück zum Zitat Barnacle S, Muir T. Intermittent urinary retention secondary to a uterine leiomyoma. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:339–41.CrossRefPubMed Barnacle S, Muir T. Intermittent urinary retention secondary to a uterine leiomyoma. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:339–41.CrossRefPubMed
14.
Zurück zum Zitat Andrada AO, De Vicente JM, Cidre MA. Pelvic plexus compression due to a uterine leiomyoma in a woman with acute urinary retention: a new hypothesis. Int Urogynecol J. 2014;25:429–31.CrossRefPubMed Andrada AO, De Vicente JM, Cidre MA. Pelvic plexus compression due to a uterine leiomyoma in a woman with acute urinary retention: a new hypothesis. Int Urogynecol J. 2014;25:429–31.CrossRefPubMed
15.
Zurück zum Zitat Parker-Autry C, Harvie H, Arya LA, Northington GM. Lower urinary tract symptoms in patients with uterine fibroids: association with fibroid location and uterine volume. Female Pelvic Med Reconstr Surg. 2011;17:91–6.CrossRefPubMed Parker-Autry C, Harvie H, Arya LA, Northington GM. Lower urinary tract symptoms in patients with uterine fibroids: association with fibroid location and uterine volume. Female Pelvic Med Reconstr Surg. 2011;17:91–6.CrossRefPubMed
16.
Zurück zum Zitat Gargasole C, Quinn S, Cartwright R, Regan L, Khullar V. The impact of bulky fibroids on LUTS: does either the size or the position make a difference? Int Urogynecol J. 2015;26:1704. Gargasole C, Quinn S, Cartwright R, Regan L, Khullar V. The impact of bulky fibroids on LUTS: does either the size or the position make a difference? Int Urogynecol J. 2015;26:1704.
17.
Zurück zum Zitat Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104:1374–9.CrossRefPubMed Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104:1374–9.CrossRefPubMed
18.
Zurück zum Zitat Giarenis I, Phillips J, Mastoroudes H, Srikrishna S, Robinson D, Lewis C, et al. Radiation exposure during video-urodynamics in women. Int Urogynecol J. 2013;24:1547–51.CrossRefPubMed Giarenis I, Phillips J, Mastoroudes H, Srikrishna S, Robinson D, Lewis C, et al. Radiation exposure during video-urodynamics in women. Int Urogynecol J. 2013;24:1547–51.CrossRefPubMed
19.
20.
Zurück zum Zitat Griffin Y, Sudigali V, Jacques A. Radiology of benign disorders of menstruation. Semin Ultrasound CT MT. 2010;31:414–32.CrossRef Griffin Y, Sudigali V, Jacques A. Radiology of benign disorders of menstruation. Semin Ultrasound CT MT. 2010;31:414–32.CrossRef
21.
Zurück zum Zitat Swithinbank L, Hashim H, Abrams P. The effect of fluid intake on urinary symptoms in women. J Urol. 2005;174:187–9.CrossRefPubMed Swithinbank L, Hashim H, Abrams P. The effect of fluid intake on urinary symptoms in women. J Urol. 2005;174:187–9.CrossRefPubMed
22.
Zurück zum Zitat Robinson D, Giarenis I, Cardozo L. You are what you eat: the impact of diet on overactive bladder and lower urinary tract symptoms. Maturitas. 2014;79:8–13.CrossRefPubMed Robinson D, Giarenis I, Cardozo L. You are what you eat: the impact of diet on overactive bladder and lower urinary tract symptoms. Maturitas. 2014;79:8–13.CrossRefPubMed
23.
Zurück zum Zitat Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481–90.CrossRefPubMedPubMedCentral Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481–90.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat McGrother CW, Donaldson MM, Thompson J, Wagg A, Tincello DG, Manktelow BN. Etiology of overactive bladder: a diet and lifestyle model for diabetes and obesity in older women. Neurourol Urodyn. 2012;31:487–95.CrossRefPubMed McGrother CW, Donaldson MM, Thompson J, Wagg A, Tincello DG, Manktelow BN. Etiology of overactive bladder: a diet and lifestyle model for diabetes and obesity in older women. Neurourol Urodyn. 2012;31:487–95.CrossRefPubMed
25.
Zurück zum Zitat Jeffcoate TNA, Francis WJA. Urgency incontinence in the female. Am J Obstet Gynecol. 1966;94:604–18.CrossRefPubMed Jeffcoate TNA, Francis WJA. Urgency incontinence in the female. Am J Obstet Gynecol. 1966;94:604–18.CrossRefPubMed
26.
Zurück zum Zitat Moore K, Dumoulin C, Bradley C, Burgio K, Chambers T, Hagen S, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. Paris, France: Health Publication Ltd; 2013. p. 1101–228. Moore K, Dumoulin C, Bradley C, Burgio K, Chambers T, Hagen S, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. Paris, France: Health Publication Ltd; 2013. p. 1101–228.
27.
28.
Zurück zum Zitat Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2010;1, CD005654.PubMed Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2010;1, CD005654.PubMed
29.
Zurück zum Zitat Andersson KE. Antimuscarinic mechanisms and the overactive detrusor: an update. Eur Urol. 2011;59:377–86.CrossRefPubMed Andersson KE. Antimuscarinic mechanisms and the overactive detrusor: an update. Eur Urol. 2011;59:377–86.CrossRefPubMed
30.
Zurück zum Zitat Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D, et al. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol. 2008;54:543–62.CrossRefPubMed Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D, et al. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol. 2008;54:543–62.CrossRefPubMed
31.
Zurück zum Zitat Veenboer PW, Bosch JL. Long-term adherence to antimuscarinic therapy in everyday practice: a systematic review. J Urol. 2014;191:1003–8.CrossRefPubMed Veenboer PW, Bosch JL. Long-term adherence to antimuscarinic therapy in everyday practice: a systematic review. J Urol. 2014;191:1003–8.CrossRefPubMed
32.
Zurück zum Zitat Aizawa N, Homma Y, Igawa Y. Effects of mirabegron, a novel beta3-adrenoceptor agonist, on primary bladder afferent activity and bladder microcontractions in rats compared with the effects of oxybutynin. Eur Urol. 2012;62:1165–73.CrossRefPubMed Aizawa N, Homma Y, Igawa Y. Effects of mirabegron, a novel beta3-adrenoceptor agonist, on primary bladder afferent activity and bladder microcontractions in rats compared with the effects of oxybutynin. Eur Urol. 2012;62:1165–73.CrossRefPubMed
33.
Zurück zum Zitat Giarenis I, Robinson D, Cardozo L. Overactive bladder and the β3-adrenoceptor agonists: current strategy and future prospects. Drugs. 2015;75:1707–13.CrossRefPubMed Giarenis I, Robinson D, Cardozo L. Overactive bladder and the β3-adrenoceptor agonists: current strategy and future prospects. Drugs. 2015;75:1707–13.CrossRefPubMed
34.
Zurück zum Zitat Lethaby A, Vollenhoven B, Sowter M. Efficacy of pre-operative gonadotrophin hormone releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy: a systematic review. BJOG. 2002;109:1097–108.CrossRefPubMed Lethaby A, Vollenhoven B, Sowter M. Efficacy of pre-operative gonadotrophin hormone releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy: a systematic review. BJOG. 2002;109:1097–108.CrossRefPubMed
35.
Zurück zum Zitat Tristan M, Orozco LJ, Steed A, Ramirez-Morera A, Stone P. Mifepristone for uterine fibroids. Cochrane Database Syst Rev. 2012;8, CD007687.PubMed Tristan M, Orozco LJ, Steed A, Ramirez-Morera A, Stone P. Mifepristone for uterine fibroids. Cochrane Database Syst Rev. 2012;8, CD007687.PubMed
36.
Zurück zum Zitat Donnez J, Vázquez F, Tomaszewski J, Nouri K, Bouchard P, Fauser BC, et al. Long-term treatment of uterine fibroids with ulipristal acetate. Fertil Steril. 2014;101:1565–73.CrossRefPubMed Donnez J, Vázquez F, Tomaszewski J, Nouri K, Bouchard P, Fauser BC, et al. Long-term treatment of uterine fibroids with ulipristal acetate. Fertil Steril. 2014;101:1565–73.CrossRefPubMed
37.
Zurück zum Zitat Pron G, Cohen M, Soucie J, Garvin G, Vanderburgh L, Bell S. The Ontario Uterine Fibroid Embolization Trial. Part 1. Baseline patient characteristics, fibroid burden, and impact on life. Fertil Steril. 2003;79:112–9.CrossRefPubMed Pron G, Cohen M, Soucie J, Garvin G, Vanderburgh L, Bell S. The Ontario Uterine Fibroid Embolization Trial. Part 1. Baseline patient characteristics, fibroid burden, and impact on life. Fertil Steril. 2003;79:112–9.CrossRefPubMed
38.
Zurück zum Zitat Pron G, Bennett J, Common A, Wall J, Asch M, Sniderman K. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptoms relief after uterine artery embolization for fibroids. Fertil Steril. 2003;79:120–7.CrossRefPubMed Pron G, Bennett J, Common A, Wall J, Asch M, Sniderman K. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptoms relief after uterine artery embolization for fibroids. Fertil Steril. 2003;79:120–7.CrossRefPubMed
39.•
Zurück zum Zitat Shveiky D, Iglesia CB, Antosh DD, et al. The effect of uterine fibroid embolization on lower urinary tract symptoms. Int Urogynecol J. 2013;24:1341–5. Prospective study using validated questionnaires to assess the impact of uterine fibroid embolisation on LUTS.CrossRefPubMed Shveiky D, Iglesia CB, Antosh DD, et al. The effect of uterine fibroid embolization on lower urinary tract symptoms. Int Urogynecol J. 2013;24:1341–5. Prospective study using validated questionnaires to assess the impact of uterine fibroid embolisation on LUTS.CrossRefPubMed
40.•
Zurück zum Zitat Cvach K, Dwyer P, Rosamilia A, Lim Y, Schierlitz L. A prospective observational study of lower urinary tract symptoms before and after surgical removal of a large pelvic mass. Int Urogynecol J. 2015;26:201–6. First prospective study using validated condition-specific questionnaires to assess the impact of surgical removal of fibroids on pre-existing LUTS.CrossRefPubMed Cvach K, Dwyer P, Rosamilia A, Lim Y, Schierlitz L. A prospective observational study of lower urinary tract symptoms before and after surgical removal of a large pelvic mass. Int Urogynecol J. 2015;26:201–6. First prospective study using validated condition-specific questionnaires to assess the impact of surgical removal of fibroids on pre-existing LUTS.CrossRefPubMed
41.
Zurück zum Zitat Dancz CE, Kadam P, Li C, Nagata K, Özel B. The relationship between uterine leiomyomata and pelvic floor symptoms. Int Urogynecol J. 2014;25:241–8.CrossRefPubMed Dancz CE, Kadam P, Li C, Nagata K, Özel B. The relationship between uterine leiomyomata and pelvic floor symptoms. Int Urogynecol J. 2014;25:241–8.CrossRefPubMed
43.
Zurück zum Zitat Gizzo S, Saccardi C, Patrelli TS, et al. Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality of-life improvements, a systematic review. Reprod Sci. 2014;21:465–76.CrossRefPubMed Gizzo S, Saccardi C, Patrelli TS, et al. Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality of-life improvements, a systematic review. Reprod Sci. 2014;21:465–76.CrossRefPubMed
44.
Zurück zum Zitat Fukunishi H, Funaki K, Shirafuji H, Maruo T. P30.15: MRgFUS treatment of uterine leiomyoma to resolve acute urinary retention: a case report. Ultrasound Obstet Gynecol. 2014;44(S1):362.CrossRef Fukunishi H, Funaki K, Shirafuji H, Maruo T. P30.15: MRgFUS treatment of uterine leiomyoma to resolve acute urinary retention: a case report. Ultrasound Obstet Gynecol. 2014;44(S1):362.CrossRef
45.
Zurück zum Zitat Nyapathy V, Polina L. MRgFUS treatment of uterine fibroid in a nulliparous woman with acute retention of urine. J Radiol Case Rep. 2012;6:1–8.PubMedPubMedCentral Nyapathy V, Polina L. MRgFUS treatment of uterine fibroid in a nulliparous woman with acute retention of urine. J Radiol Case Rep. 2012;6:1–8.PubMedPubMedCentral
46.
Zurück zum Zitat Niël-Weise BS, van den Broek PJ, da Silva EM, Silva LA. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev. 2012;8, CD004201.PubMed Niël-Weise BS, van den Broek PJ, da Silva EM, Silva LA. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev. 2012;8, CD004201.PubMed
Metadaten
Titel
Management of Urinary Symptoms Associated with Fibroids
verfasst von
Christos Kleanthis
Martino Zacchè
Ilias Giarenis
Publikationsdatum
28.03.2016
Verlag
Springer US
Erschienen in
Current Obstetrics and Gynecology Reports / Ausgabe 2/2016
Elektronische ISSN: 2161-3303
DOI
https://doi.org/10.1007/s13669-016-0151-5

Weitere Artikel der Ausgabe 2/2016

Current Obstetrics and Gynecology Reports 2/2016 Zur Ausgabe

Uterine Fibroids (N Narvekar, Section Editor)

Uterine Fibroid Mapping

Uterine Fibroids (N Narvekar, Section Editor)

Office Hysteroscopic Treatment of Uterine Fibroids

Pelvic Organ Prolapse (M Weinstein, Section Editor)

Concomitant Incontinence Surgery at the Time of Prolapse Repair

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.