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Intramural myomas, the most common type of uterine leiomyoma, develop within the uterine wall and expand either inwards or outwards. According to the FIGO  leiomyoma classification system, fibroid types range from 0 to 8. Types 0, 1 and 2 are submucosal myomas, and subserosal myomas refer to type 5 to 7. Both type 3 and type 4 myomas are known as intramural myomas with no involvement of the endometrial cavity (Figure 13.1). The type 3 myomas, which are in the uterine wall but in contact with the endometrium, are more likely to distort the cavity under certain stimulations. Type 4 myomas stay entirely within the myometrium, which does not expand to either the endometrium or the serosa.
Uterine fibroids or leiomyomas are the most common benign gynaecological tumours; up to 25–30% of women may be diagnosed with fibroids during their lifetime . Women with uterine fibroids may be asymptomatic, or they may present with menstrual symptoms such as menorrhagia and dysmenorrhoea, pressure symptoms, infertility, recurrent miscarriage or complications during pregnancy like red degeneration.
Uterine fibroids are very common in women of reproductive age and are mostly benign. However, they are often a cause of abnormal bleeding and, in severe cases, can cause infertility. This comprehensive guide reviews the clinical management of uterine fibroids, with a particular focus on practical surgical techniques. Engage with topics such as the anatomy of the pelvis, key theatre equipment and surgical treatments including hysteroscopic and laparoscopic techniques. Features also include debates around morcellation, and less invasive treatments such as uterine artery embolisation are also covered. An online video library of surgical procedures reinforces the practical techniques taught in the book and detailed colour images supplement the book's thorough coverage of fibroid management. This makes Modern Management of Uterine Fibroids an essential resource for practicing gynaecologists and IVF specialists, as well as students.
Heinrich Fritsch reported the first case of intrauterine adhesions (IUAs) at the end of the nineteenth century. Since 1948, a series of papers on this condition have been published by Joseph G. Asherman, which describe the frequency, aetiology and symptoms of IUA
Congenital uterine anomalies (CUAs) are gaining increasing attention in the field of gynaecological ultrasound for a number of reasons: first, they appear to be of relatively high prevalence in both selected and unselected groups of women ; second, they appear to have a significant impact on reproductive outcomes and, on occasion, in adolescent symptomatology ; third, there has been a recent surge in relevant publications, which has culminated in a new international classification , and also a new international consensus for diagnosis. Three-dimensional (3D) ultrasound is now recommended as the gold standard method for diagnosis, which implies that gynaecologists and/or sonographers may be expected to attain the correct diagnoses and classification of CUA for women presenting to them with, and even without, symptomatology.
Engage with practical and active solutions to day-to-day issues of reproductive medicine and the use of artificial reproductive techniques (ART), occurring in clinical and laboratory environments. Authored by leading experts in the field, this user-friendly guide is invaluable for any IVF practitioner and embryologist, facing everyday hands-on issues, through to high-pressure laboratory problems, efficiency ratings and ensuring cost-effective delivery of care. With the strict governance of regulatory bodies worldwide, the success of any fertility centre depends on successful problem solving, all day every day. Based on a wealth of experience, identify commonly occurring problems, and fresh perspectives of problem-solving, with 'must-have' protocols, patient information sheets and suggested equipment. This go-to companion tackles operational, organisational, clinical and laboratory issues to financial and clinical governance, with a focus on quick and effective solutions for the busy practitioner.