EFFICIENCY OF DIFFERENTIATION HORMONE THERAPY AFTER LAPAROSCOPIC MYOMECTOMY
- Authors: YARMOLINSKAYA M.I1, BEZHENAR V.F1, DOLINSKY A.K1, KAKHIANI M.I1, CHMARO M.G2
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Affiliations:
- D.O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences
- L.G. Sokolov Clinical Hospital One Hundred and Twenty-Two, Federal Biomedical Agency of Russia
- Issue: No 8 (2013)
- Pages: 108-112
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/247082
- ID: 247082
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Abstract
Background. Along with drug treatments, laparoscopic myomectomy, a reconstructive and plastic operation, has been increasingly used to treat uterine myoma in patients who are planning pregnancy. In this period, the major goals of rehabilitation in patients undergoing laparoscopic myomectomy are to ensure reliable contraception and to reduce the risk of recurrence. These requirements are met with a group of combined contraceptives. Objective. To evaluate the efficiency and safety of using different combined contraceptives (CC) after laparoscopic myomectomy in infertile patients planning pregnancy. Subject and methods. The paper analyzes the experience with CC used within 6 months after laparoscopic myomectomy in patients planning pregnancy. According to body mass index and the presence of hypertension, the patients enrolled in the trial were divided into 3 groups: 1) 47 patients receiving a CC containing 15 μg ethinylestradiol and ethonogestrel; 2) 79 patients taking a CC containing 20 μg ethinylestradiol and desogestrel; 3) 37 women having 30 μg ethinylestradiol and drospirenone. The authors analyzed the incidence of recurrent uterine myoma 6 months after the use of a CC containing different amounts of an estrogen component and the tolerance and reliability of the contraceptive effect of the test agents. Results. In the patients receiving the combined contraceptive containing 15 μg ethinylestradiol and 0.12 mg ethonogestrel (the vaginal ring Novaring), recurrent uterine myoma was diagnosed in 1 (2.1%) case. In those taking a combined oral contraceptive (COC) containing 20 μg of ethinylestradiol and 15 μg desogestrel (novinet), it was noted in 3 (3.8%) cases, and in the women having 30 μg ethinylestradiol and 3 μg drospirenone (midiana), it was seen in 5 (13.5%) cases. No significant side effects were observed, neither were pregnancy cases with the use of the test agents. Conclusion. The test CCs may be recommended for the rehabilitation of patients undergoing laparoscopic myomectomy. However, the approach to choosing hormone therapy must be differentiated in relation to the presence of metabolic comorbidities and the family history of uterine myoma.
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About the authors
M. I YARMOLINSKAYA
D.O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences
Email: m.yarmolinskaya@gmail.com
Saint Petersburg
V. F BEZHENAR
D.O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences
Email: bez-vitaly@yandex.ru
Saint Petersburg
A. K DOLINSKY
D.O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences
Email: dolinskiy.andrey@yandex.ru
Saint Petersburg
M. I KAKHIANI
D.O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences
Email: kakhiani74@mail.ru
Saint Petersburg
M. G CHMARO
L.G. Sokolov Clinical Hospital One Hundred and Twenty-Two, Federal Biomedical Agency of Russia
Email: mariachmaro@yandex.ru
Saint Petersburg
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