Lower Urinary Tract Infection (UTI) Evaluation in Women With Uterine Leiomyomata
Lower Urinary Tract Infection (UTI) Evaluation in Women With Uterine Leiomyomata
To the investigators knowledge there is no research data published to date regarding the
 lower urinary tract symptoms in women with leiomyomas. The primary aims of this study are:

 1. To determine prevalence of lower urinary tract symptoms in patients who present for care
 for symptomatic leiomyomata.

 2. To compare change in lower urinary tract symptoms within treatment groups measured by
 the UDI-6 total before and at six months after three common treatments for symptomatic
 uterine fibroids including: hysterectomy, myomectomy, or uterine artery embolization.

 The study proposed here will hopefully answer the question if one particular therapy is
 appropriate to treat fibroids and relieve lower urinary tract symptoms.
1. Uterine fibroids Uterine leiomyomas or fibroids are one of the most common conditions
 affecting women of reproductive age. They account for approximately a third of all
 hysterectomies performed. Symptoms often attributed to uterine leiomyomas include
 excessive menstrual bleeding, dysmenorrhea, pelvic pain, and so called "bulk symptoms,"
 or symptoms related to pressure on adjacent organs such as ureteral obstruction, urinary
 frequency and urgency, rectal pressure, pelvic pressure and increasing abdominal girth.
 Current treatment for symptomatic uterine fibroids includes hysterectomy, myomectomy and
 uterine fibroid embolization.

 2. Lower urinary tract symptoms Although, urinary symptoms like frequency, urgency,
 incontinence, and voiding dysfunction are often attributed to fibroids, the relationship
 between fibroids and lower urinary tract symptoms (LUTS) has been poorly studied. The
 public health burden of fibroids has been studied before and after radical hysterectomy,
 supracervical hysterectomy, and total abdominal hysterectomy.(1-3) What is missing in
 the literature is a comparison of traditional and non-traditional surgical fibroid
 techniques in a prospective fashion. Moreover, there are no studies evaluating the
 relationship between anatomic factors like uterine size or fibroid number or location
 and the presence of LUTS.
Inclusion Criteria:

 -  Patients who are at least 18 years of age,

 -  Vaginal bleeding secondary to anatomic uterine leiomyomas confirmed at the Cleveland
 Clinic Fibroid and Menstrual Disorders Center,

 -  Patients complaining of mass effect symptoms due to fibroids, and

 -  Patients undergoing either hysterectomy, myomectomy, or uterine artery embolization

 Exclusion Criteria:

 -  Patients who are pregnant, or

 -  Diagnosis of solitary or multiple intracavitary fibroids without subserosal or
 intramural leiomyomas present, or

 -  Prior or interval anti-incontinence procedure, or

 -  Patients with a urinary tract infection, or

 -  Patients taking anti-cholinergic medications, or

 -  Presence of an adnexal mass, or

 -  Unable or unwilling to complete a follow up survey at six months following treatment