Cervicovaginal fibroids: a systematic review for a comprehensive management plan
Leiomyomas are the most common benign tumors of the female genital tract. However, cervical leiomyomas are rare, with a prevalence of only 0.6%. The location of cervicovaginal leiomyomas near important organs and vessels makes the approach to their management more critical. Traditionally, a vaginal approach was considered the gold standard for cervicovaginal myomectomy. However, hymen integrity in some societal cultures makes a vaginal approach more difficult. It is for this reason that surgeons usually switch to traditional laparotomy or, more recently, to laparoscopy. With the advancement in endoscopy and its application in gynecologic surgery, laparoscopy has become a feasible option. In addition, the size of the cervicovaginal leiomyoma is a determining factor for the management approach and choice of appropriate surgical technique. The aim of this article is to provide a general treatment plan in the management of cervical leiomyomas and the special considerations to be accounted for, such as hymen integrity and size limits.