USE OF ANTIPROGESTINS TO PREVENT RELAPSES AFTER CONSERVATIVE MYOMECTOMY
- Authors: Fatkullin I.F1, Bakanova A.R1
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Affiliations:
- Kazan State Medical University
- Issue: No 1 (2011)
- Pages: 101-104
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/246550
- ID: 246550
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Abstract
Objective. To evaluate the efficacy and safety of antiprogestins versus gonadotropin-releasing hormone agonists in adjuvant therapy after conservative myomectomy. Subjects and methods. Sixty-nine reproductive-age women with uterine myoma underwent enucleation of myomatous nodules by laparotomic, laparoscopic, or transcervical access. To prevent recurrent myoma, Group 1 patients were given the antiprogestin mifepristone (50 mg daily for 4 months); Group 2 was administered gonadotropin-releasing hormone agonists (triptorelin or leuroprorelin 3.75 mg as a single intramuscular injection every 28 days for 6 months); Group 3 women used oral contraceptives after surgery. Transvaginal echography and Doppler study were regularly performed during 2 years. Results. The recurrence rate of uterine myomas was significantly lower in the group of patients receiving adjuvant therapy than in those taking oral contraceptives (8.6 and 34.7%, respectively). Conclusion. Postoperative adjuvant therapy with mifepristone or gonadotropin-releasing hormone agonists significantly reduces the risk of recurrent uterine myoma; moreover, the antiprogestin drug shows fewer adverse events and better tolerability.
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About the authors
I. F Fatkullin
Kazan State Medical University
Email: fatkullin@yandex.ru
A. R Bakanova
Kazan State Medical University
References
- Вихляева Е.М., Савельева И.С., Городничева Ж.А. Возможности клинического применения антипрогестинов в акушерстве и гинекологии // Вопр. гинекол., акуш. и перинатол. — 2007. — № 2. — C. 58—63.
- Ланчинский В.И. Современные. представления об этиологии и патологии миомы матки // Вестн. гинекол. и перинатол. — 2003. — № 5—6. — C. 64—69.
- Самойлова Т.Е., Аль-Сейкал Т.С. Перспективы применения мифепристона в лечении гормональнозависимых заболеваний у женщин // Пробл. репродукции. — 2004. -№ 6. — С. 35— 42.
- Самойлова Т.Е. Перспективы применения аналогов рилизинг гормона, гонадотропинов и антигестагенов в комбинированном лечении больных с лейомиомой матки // Акуш. и гин. — 2006. — № 1, прилож. — С. 34—40.
- Тихомиров А.Л., Лубнин Д.М. Оптимизация лечения больных миомой матки // Вопр. гинекол., акуш. и перинатол. — 2005. — № 2. — C. 2—8.
- Buffet N.C., Meduri G. et al. Selective progesterone receptor modulators and progesterone antagonists: mechanisms of action and clinical applications // Human Reproduction Update. — 2005. — № 3. — P. 293—307.
- Eisinger S.H., Fiscella J. et al. Open-label study of ultra low-dose mifepristone for the treatment of uterine leiomyomata // Eur. J. Obstet. Gynecol. Reprod. Biol. — 2009. — № 7. — P. 215—218.
- Heikinheimo O., Kekkonen R., Lahteenmaki P. The pharmacokinetics of mifepristone in humans reveal insights into differential mechanisms of antiprogestin action. // Contraception. — 2003. — № 6. — P. 421— 426.
- Hanafi M. Predictors of Leiomyoma Recurrence After Myomectomy // Obstetrics & Gynecology. — 2005. — Vol. 105 — № 4. — P. 877—881.
- Sachie N., Mayuko S., Kodo S. High Recurrence Rate of Uterine Fibroids on Transvaginal Ultrasound after Abdominal Myomectomy in Japanese Women // Gynecol. Obstet Invest. — 2006. — № 6. — P. 155— 159.
- Yoo E.H., Lee P.I. et al. Predictors of leiomyoma recurrence after laparoscopic myomectomy // J. оf Minimally Invasive Gynecology. — 2007. — Vol. 14, № 6. — P. 690—697.
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