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Open research questions in Uterine Myomas and Treatments

42 unresolved questions extracted from the limitations and future-work sections of 426 Uterine Myomas and Treatments papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Although they are encountered in gynaecological practice, prolapsed uterine fibroids are a relatively uncommon complication of uterine fibroids and represent an impor- tant but frequently under-recognized aspect of gynaecological health. Despite this, the phenomenon of prolapsed uterine fibroids remains relatively poorly understood.

    Management of an infected prolapsed pedunculated submucosal leiomyoma in a postmenopausal woman: a case report · 2026 · DOI

  • Therefore, the estimated association in the upper serum cal- cium range may be less stable and should be validated in larger independent populations. Finally, although mediation analysis sug- gests that inflammation and lipid indicators play a certain role between serum calcium and UL, this study still lacks direct mecha- nistic evidence, and the relevant molecular pathways need to be further validated through basic experiments and multi omics research. Nevertheless, the current evidence is insufficient to support routine serum calcium screening or calcium supplementation as preventive strategies in clini- cal practice. Future prospective and mechanistic studies are warranted to further elucidate the biological pathways link- ing serum calcium, lipid metabo- lism, and UL.

    Association between serum calcium levels and uterine leiomyoma: a retrospective case–control study exploring the potential mediating roles of inflammatory and lipid-related indicators · 2026 · DOI

  • Sixth, pain evaluation was limited to a single POD1 VAS measurement. Further interpretive caution is warranted for the robotic learning curve: the inflection point occurred at an early stage within only 35 total RASPH cases, leaving a limited number of post-proficiency procedures to benchmark stable performance.

    Perioperative outcomes and learning curves of minimally invasive hysterectomy: a comparative analysis of MPLH, RASPH, and SPLH · 2026 · DOI

  • The precise underlying etiology remains unknown, although the main hypothesis for primary peritoneal leiomyomatosis is smooth muscle metaplasia within the submesothelial mesenchymal cells of the peritoneal lining resulting from transformation under hormonal stimulation [18, 19]. Again, the focus was mainly on rare cases of cancer and not the much more frequent SPL complication, which remains under-recognized.

    Secondary peritoneal leiomyomatosis after uterine leiomyoma intervention: multi-institutional clinical and radiologic experience · 2026 · DOI

  • Beyond biological mechanisms, future studies should investigate patient-level, provider-level, and hospital- level contributors to inequities in myomectomy outcomes. Additionally, refinement and external validation of our predictive model in diverse populations and practice settings are warranted.

    Racial disparities and risk factors for blood transfusion in patients undergoing myomectomy for uterine fibroids: insights from a national surgical database · 2026 · DOI

  • This study has several limitations that must be taken into account when interpreting the results. First, it is a ques- tionnaire-based survey that is potentially influenced by recall bias, as the information on sexual function is based on subjective self-reports from the patients. In addition, participation was voluntary, which means that selection bias among participants cannot be ruled out. Furthermore, potential influencing factors such as hormonal status or psychological comorbidities were not adequately recorded. Finally, the sample size is limited, which restricts the significance of the results, particularly for any subgroup analyses. In addition, attrition may have occurred, as there are significantly fewer complete follow-up results for the LASH group (n = 29) than for the TLH group (n = 45).

    Sexual functioning after total versus subtotal laparoscopic hysterectomy—long term follow up results after 7 years · 2026 · DOI

  • This study was conducted in a single tertiary care hospital with a relatively small sample size of 150 adolescent girls, which may the adolescent findings population. As the study was based on purposive sampling and cross-sectional design, causal relationships could not be established. In addition, follow-up data were not collected, which limits assessment of treatment response.

    Evaluation of Adolescent Girls with Abnormal Uterine Bleeding in a Gynecology Outpatient Department · 2026 · DOI

  • The organ culture platform revealed stem cell activation in normal myometrium with potential for investigating proliferation, differentiation, and ECM remodeling mechanisms fundamental to tissue function. This approach should be extended to other fibrotic conditions (liver, pulmonary, and cardiac fibrosis) using available slice culture methods to identify whether resident stem cell activation is a common mechanism promoting fibrotic remodeling across tissues.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • Partial RNA degradation and low RIN values in some samples may have reduced transcript coverage and affected RNA integrity. Future studies should establish minimum RNA quality standards and employ methods for compensating RNA degradation in organ culture samples to improve transcriptome coverage in uterine leiomyomas and myometrium.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • The study focused exclusively on MED12-mutated leiomyomas, the most prevalent genetic subtype of uterine fibroids. Transcriptional programs and pathway dynamics must be characterized in other genetic subtypes (HMGA2-rearranged, FUBP1-mutated, or wild-type leiomyomas) to determine whether the metabolic, fibrotic, vascular, and immune dysregulation mechanisms are shared or distinct across leiomyoma subtypes.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • All long-term culture samples were pooled into a single endpoint group, eliminating temporal resolution of stem cell activation, proliferation, and differentiation processes. Future studies must analyze matched intermediate time points (T15, T20, T25, T29) compared to T0 controls to reconstruct the differentiation trajectory and identify genes activated early versus late along the stem cell-to-myocyte developmental axis.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • Hypoxia-related signaling was identified as prominent in pathway enrichment analyses of long-term cultures in both myometrium and uterine leiomyomas, but hypoxia was not directly measured. Direct measurement of oxygen tension, HIF-1α stabilization, and hypoxia-inducible factor activity is needed to establish causality between hypoxic conditions and stem cell activation.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • The study analyzed transcriptomic data exclusively without direct measurement of protein abundance, post-translational modifications, or functional activity in uterine leiomyomas stem cell cultures. Proteomic validation and functional assays are needed to confirm whether dysregulated transcripts translate to altered protein levels and biological activity in the metabolic, fibrotic, vascular, and immune pathways identified.

    Stem cell activation in organ culture reveals novel transcriptional programs underlying metabolic, fibrotic, vascular, and immune dysregulation in uterine leiomyomas · 2026 · DOI

  • Although there have been increasing numbers of studies exploring the molecular environment of smooth muscle leiomyosarcoma and identifying chromosomal aberrations or heterozygous deletions (chromosomes 2p, 2q, 10q, 13q) and dysregulated genes (TP53, RB1, PTEN, MED12, YWHAE, VIPR2) associated with the pathogenesis and the disease, molecular events of most leiomyosarcomas remain unknown (Sanegre et al.

    Identification of the key immune and inflammatory related gene CALCRL as diagnostic biomarker in differentiating uterine leiomyosarcoma from leiomyoma · 2026 · DOI

  • Although late presentation may contribute to severe symptoms and complications among women with UF in Africa, other factors that influence severity and increase incidence in this population remain unknown.

    Probing Genetics and Environmental Factors underlying Uterine Fibroid Tumorigenesis in Ghana, West Africa · 2024 · DOI

  • Bortezomib, a reversible proteasome inhibitor targeting the β5 subunit of the 26S proteasome, is approved for hematologic malignancies but has not been systematically evaluated in uterine leiomyomas.

    Bortezomib Is Associated With Stress Responses and Growth Suppression in ELT3 Uterine Leiomyoma Cells · 2026 · DOI

  • Hysteroscopy is invaluable for both direct visualization and therapeutic resection, while immunohistochemistry is essential for definitive diagnosis—particularly when initial histopathology is inconclusive.

    Submucosal uterine leiomyoma with complete cystic degeneration mimicking an empty gestational sac: a case report and literature review · 2026 · DOI

  • This report adds to the limited literature on successful pregnancy after uterine adenosarcoma and discusses indications and limitations of fertility-sparing treatment.

    Fertility-sparing strategy in a rare case of uterine adenosarcoma and consecutive spontaneous pregnancy and livebirth · 2026 · DOI

  • Vitamin D supplementation may warrant further investigation as a potential adjunctive strategy for limiting fibroid progression and reducing disease burden, which may ultimately decrease the need for surgical intervention.

    Cross-Sectional Assessment of the Association Between Circulating 25(OH)D Levels and Uterine Fibroid Occurrence Among Libyan Women of Reproductive Age · 2026 · DOI

  • The relationship between specific number, size and position of myomas (excluding submucosal myomas or intramural myomas that distort the endometrial cavity) with the outcomes of pregnancy has not been verified.

    Fibromas and Infertility. What is the Role of Myomectomy in the Improvement of Fertility? · 2024 · DOI

  • Further study of the correlation of clinical and paraclinical parameters can make it possible to predict the course of uterine fibroids, and therefore to apply an effective personalized treatment plan.

    Theranostics of uterine leiomyoma: present and future · 2023 · DOI

  • The genetic influence on the outcome is not yet fully explored; although Afro-American women seem to have equal results, major studies in European are still pending (Torres-de la Roche et al.

    The future of (non-)surgical ablative therapy in uterine adenomyosis · 2022 · DOI

  • OBJECTIVES: This study aims to investigate the rates of extra-uterine metastases of non-endometrioid endometrial tumors limited to the half of the myometrium.

    Investigation of extra-uterine tumor dissemination of endometrial cancers with myometrial invasion less than 50% according to hystologic subtypes · 2019 · DOI

  • It appears that for some, limited knowledge regarding fibroids and normal menstruation may lead to a distorted view of what is normal with regard to uterine bleeding, resulting in limited treatment seeking behavior.

    An Altered Perception of Normal: Understanding Causes for Treatment Delay in Women with Symptomatic Uterine Fibroids · 2016 · DOI

  • Investigation into the clinical effects of laparoscopic myomectomy and uncontained morcellation on the prognosis and spread of occult leiomyosarcoma has yielded mixed results.

    An Interview with Rick Parente: Head Injury and Brain Trauma · 2010 · DOI

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42 open questions have been extracted from the limitations and future-work passages of 426 Uterine Myomas and Treatments papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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