Evidence-Based Indications for Treatment of Uterine Fibroids in Gynecology

Uterine fibroids affect quality of life, as well as obstetric and fertility outcomes. There is considerable evidence on which to base clinical intervention for symptoms caused by fibroids, such as bleeding, pain, sexual dysfunction, and infertility. The most appropriate treatment will be largely influenced by the patient's symptoms, age, and desire for fertility or to retain her uterus. Evidence-based treatment of fibroids depends on the size, location, and number of fibroid(s) present. Thus, accurate assessment of the size, number, and location of the fibroid(s) is necessary to design individualized management and treatment to obtain optimal outcomes. In this chapter we review the evidence relating to fibroid symptoms and the indications for treatment of symptomatic uterine fibroids by medical, surgical, and minimally invasive methods.