TY - JOUR

T1 - Innovative approaches to reproductive function recovery in patients with uterine myoma

AU - Bezhenar, Vitaly F.

AU - Komlichenko, Eduard V.

AU - Yarmolinskaya, Maria I.

AU - Dedul, Anna G.

AU - Sheveleva, Tatyana S.

AU - Malushko, Anton V.

AU - Kalinina, Evgenia A.

AU - Zubareva, Tatiana M.

AU - Gamzatova, Zainab Kh

AU - Kondrat’ev, Anton A.

N1 - Publisher Copyright: © Bionika Media Ltd.

PY - 2016

Y1 - 2016

N2 - Uterine myoma (UM) is the most common benign tumor of the uterus and it occurs in 20-40% of reproductiveaged women, which substantially diminishes female reproductive function. UM has been still treated surgically so far and it is the most common reason for hysterectomy. Subjects and methods. The study included 234 patients aged 29–45 years with symptomatic UM who planned pregnancy and received the selective progesterone receptor modulator ulipristal acetate 5 mg for 3 months. Surgical treatment was planned for the women. Results. In 141 (60.3%) women, amenorrhea occurred during 7–9 days. After treatment, there was an obvious reduction in anemia (mild anemia in 108 (46.2%) women; a normal hemoglobin level in 126 (53.8%) women; p > 0.05). The mean decrease in uterine sizes was 30.7% (minimum 8% from 425 to 391 cm3; maximum 78%, from 1282 to 282 cm3); UM was reduced by 27.8% (minimum 12%, from 285 to 251 cm3; maximum 55%, from 949 to 427 cm3). In 54 (23.1%) women, the sizes of the uterus and myomatous nodules were unchanged. Laparoscopy, myomectomy were successfully performed in 216 (92.3%) patients. Surgery could be avoided in 18 (7.7%) patients after cycle therapy (p > 0.05). Conclusion. The innovative approach to using ulipristal acetate led to substantial UM regression, which permitted surgical treatment with a minimal impact on the uterine cavity, improving a reproductive prognosis.

AB - Uterine myoma (UM) is the most common benign tumor of the uterus and it occurs in 20-40% of reproductiveaged women, which substantially diminishes female reproductive function. UM has been still treated surgically so far and it is the most common reason for hysterectomy. Subjects and methods. The study included 234 patients aged 29–45 years with symptomatic UM who planned pregnancy and received the selective progesterone receptor modulator ulipristal acetate 5 mg for 3 months. Surgical treatment was planned for the women. Results. In 141 (60.3%) women, amenorrhea occurred during 7–9 days. After treatment, there was an obvious reduction in anemia (mild anemia in 108 (46.2%) women; a normal hemoglobin level in 126 (53.8%) women; p > 0.05). The mean decrease in uterine sizes was 30.7% (minimum 8% from 425 to 391 cm3; maximum 78%, from 1282 to 282 cm3); UM was reduced by 27.8% (minimum 12%, from 285 to 251 cm3; maximum 55%, from 949 to 427 cm3). In 54 (23.1%) women, the sizes of the uterus and myomatous nodules were unchanged. Laparoscopy, myomectomy were successfully performed in 216 (92.3%) patients. Surgery could be avoided in 18 (7.7%) patients after cycle therapy (p > 0.05). Conclusion. The innovative approach to using ulipristal acetate led to substantial UM regression, which permitted surgical treatment with a minimal impact on the uterine cavity, improving a reproductive prognosis.

KW - Epigenetics

KW - Hormone therapy

KW - Infertility

KW - Laparoscopy

KW - Myomectomy

KW - Ulipristal acetate

KW - Uterine myoma

UR - http://www.scopus.com/inward/record.url?scp=84995486559&partnerID=8YFLogxK

U2 - 10.18565/aig.2016.1.80-87

DO - 10.18565/aig.2016.1.80-87

M3 - Article

AN - SCOPUS:84995486559

SP - 80

EP - 87

JO - АКУШЕРСТВО И ГИНЕКОЛОГИЯ

JF - АКУШЕРСТВО И ГИНЕКОЛОГИЯ

SN - 0300-9092

IS - 1

ER -