INNOVATIVE APPROACHES TO REPRODUCTIVE FUNCTION RECOVERY IN PATIENTS WITH UTERINE MYOMA


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Abstract

Uterine myoma (UM) is the most common benign tumor of the uterus and it occurs in 20-40%) of reproductive- aged 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 234patients aged 29-45 years with symptomatic UM who planned pregnancy and received the selective progesterone receptor modulator ulipristal acetate 5 mgfor 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.

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About the authors

Vitaly Fedorovich Bezhenar

Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: bez-vitaly@yandex.ru
MD, Professor, Head of the Department of Obstetrics

Eduard Vladimirovich Komlichenko

University Clinic, Saint Petersburg State University

Email: e_komlichenko@mail.ru
MD, Professor Saint-Petersburg 198103, Fontanka Embankment 154, Russia

Maria Igorevna Yarmolinskaya

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: m.yarmolinskaya@gmail.com
Leading researcher of the Department of Reproduction Endocrinology Saint-Petersburg 199034, Mendeleevskaya line 154, Russia

Anna Gennad'evna Dedul

University Clinic, Saint Petersburg State University

Email: deag@list.ru
MD, PhD, obstetrician-gynecologist in the Department of Family Planning and Human Reproduction Saint-Petersburg 198103, Fontanka Embankment 154, Russia

Tatyana Sergeevna Sheveleva

Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: sheveleva.t@bk.ru
MD, Chief of the Gynecology Department, Clinic of Obstetrics and Gynecology

Anton Viktorovich Malushko

University Clinic, Saint Petersburg State University

Email: a-malushko@mail.ru
MD Saint-Petersburg 198103, Fontanka Embankment 154, Russia

Evgenia Aleksandrovna Kalinina

University Clinic, Saint Petersburg State University

Email: evgenia_kalinina@list.ru
MD Saint-Petersburg 198103, Fontanka Embankment 154, Russia

Tatiana Mikhaylovna Zubareva

V.A. Almazov North-Western Federal Medical Research Center, Ministry of Health of Russia

Email: Tamizu@yandex.ru
MD

Zainab Khizrievna Gamzatova

V.A. Almazov North-Western Federal Medical Research Center, Ministry of Health of Russia

Email: Tamizu@yandex.ru
MD, Licentiate

Anton Aleksandrovich Kondrat’ev

Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: Kondratyev90tony@rambler.ru
Assistant professor of the Department of Obstetrics

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