Leiomioma uterino: opciones terapéuticas actuales

Abstract

Uterine leiomyomas are the most common benign tumors in reproductive-age women. However, it is difficult to establish its incidence because only a minority of cases present symptoms, where compressive and hemorrhagic clinical pictures stand out that require timely management. Among the therapeutic alternatives drugs, minimally invasive techniques, myomectomy and hysterectomy are mentioned. Generally, the resolution capacity depends on the characteristics of the fibroid and the preferences of the patient regarding pregnancy. Objective: To analyze the current therapeutic alternatives used in uterine leiomyoma to improve the approach to this pathology in obstetric and gynecological patients. Method: Bibliographic review of the literature based on the selection of scientific articles from recent years based on the PRISMA method. Results: There are drugs capable of improving the clinical picture and stopping the growth of the fibroid, and at the same time, schemes that show insufficient or inconclusive results or serious adverse effects and, therefore, are not approved. On the other hand, the application of less invasive procedures depends on their availability, their resolving efficacy, the need for reintervention or the choice of subsequent surgery, which includes myomectomy and hysterectomy. Conclusion: Treatment of uterine leiomyoma should be individualized in all cases. Medical pharmacological schemes and myomectomy in its different modalities are the therapeutic pillar in women who wish to preserve fertility. Otherwise, you can opt for more aggressive methods; however, if possible, alternatives should be considered, leaving hysterectomy as the last option.